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  • US - CDC: COVIDView 2020/2021 - Not offered for exactness - Offered for trend analysis only

    COVIDView: A Weekly Surveillance Summary of U.S. COVID-19 Activity
    This CDC report provides a weekly summary and interpretation of key indicators being adapted to track
    the COVID-19 pandemic in the United States. This includes information related to COVID-19 outpatient
    visits, emergency department visits, hospitalizations and deaths, as well as laboratory data.
    ...


    Key Points
    o CDC is modifying existing surveillance systems, many used to track influenza and other respiratory
    viruses annually, to track COVID-19.
    o Visits to outpatient providers and emergency departments for illnesses with symptom presentation
    similar to COVID-19 are elevated compared to what is normally seen at this time of year. At this time,
    there is little influenza virus circulation.
    o The overall cumulative COVID-19 associated hospitalization rate is 4.6 per 100,000, with the highest
    rates in persons 65 years and older (13.8 per 100,000) and 50-64 years (7.4 per 100,000). These rates
    are similar to what is seen at the beginning of an annual influenza epidemic.
    o The percentage of deaths attributed to pneumonia and influenza increased to 8.2% and is above the
    epidemic threshold of 7.2%. The percent of deaths due to pneumonia has increased sharply since the
    end of February, while those due to influenza increased modestly through early March and declined this
    week. This could reflect an increase in deaths from pneumonia caused by non-influenza associated
    infections including COVID-19.
    o NCHS is monitoring deaths associated with COVID-19 and made those data publicly available on April 3,
    2020.

    ...
    https://www.cdc.gov/coronavirus/2019.../covidview.pdf
    Twitter: @RonanKelly13
    The views expressed are mine alone and do not represent the views of my employer or any other person or organization.

  • #2
    Provisional Death Counts for Coronavirus Disease (COVID-19)


    alert icon

    Note: Provisional death counts are based on death certificate data received and coded by the National Center for Health Statistics as of April 3, 2020. Death counts are delayed and may differ from other published sources (see Technical Notes). Counts will be updated periodically. Additional information will be added to this site as available.



    The provisional counts for coronavirus disease (COVID-19) deaths are based on a current flow of mortality data in the National Vital Statistics System. National provisional counts include deaths occurring within the 50 states and the District of Columbia that have been received and coded as of the date specified. It is important to note that it can take several weeks for death records to be submitted to National Center for Health Statistics (NCHS), processed, coded, and tabulated. Therefore, the data shown on this page may be incomplete, and will likely not include all deaths that occurred during a given time period, especially for the more recent time periods. Death counts for earlier weeks are continually revised and may increase or decrease as new and updated death certificate data are received from the states by NCHS. COVID-19 death counts shown here may differ from other published sources, as data currently are lagged by an average of 1–2 weeks.

    The provisional data presented on this page include the weekly provisional count of deaths in the United States due to COVID-19, deaths from all causes and percent of expected deaths (i.e., number of deaths received over number of deaths expected based on data from previous years), pneumonia deaths (excluding pneumonia deaths involving influenza), and pneumonia deaths involving COVID-19; (a) by week ending date, (b) by age at death, and (c) by specific jurisdictions. Future updates to this release may include additional detail such as demographic characteristics (e.g., sex), additional causes of death (e.g., acute respiratory distress syndrome or other comorbidities), or estimates based on models that account for reporting delays to generate more accurate predicted provisional counts.

    Pneumonia deaths are included to provide context for understanding the completeness of COVID-19 mortality data and related trends. Deaths due to COVID-19 may be misclassified as pneumonia deaths in the absence of positive test results, and pneumonia may appear on death certificates as a comorbid condition. Thus, increases in pneumonia deaths may be an indicator of excess COVID-19-related mortality. Additionally, estimates of completeness for pneumonia deaths may provide context for understanding the lag in reporting for COVID-19 deaths, as it is anticipated that these causes would have similar delays in reporting, processing, and coding. However, it is possible that reporting of COVID-19 mortality may be slower or faster than for other causes of death, and that the delay may change over time. Analyses to better understand and quantify reporting delays for COVID-19 deaths and related causes are underway. The list of causes provided in these tables may expand in future releases as more data are received, and other potentially comorbid conditions are determined.
    Download DatasetsTable 1. Deaths involving coronavirus disease 2019 (COVID-19) and pneumonia reported to NCHS by week ending date, United States. Week ending 2/1/2020 to 3/28/2020.*


    Data as of 4/3/2020
    Total Deaths 1,150 446,778 86 24,741 469
    02/01/20 0 56,061 94 2,991 0
    02/08/20 0 56,209 94 2,985 0
    02/15/20 0 54,463 92 2,863 0
    02/22/20 0 54,017 93 2,833 0
    02/29/20 5 53,697 93 2,831 2
    03/07/20 16 52,506 91 2,826 5
    03/14/20 41 48,577 85 2,730 17
    03/21/20 300 42,750 74 2,642 121
    03/28/20 788 28,498 50 2,040 324
    NOTE: Number of deaths reported in this table are the total number of deaths received and coded as of the date of analysis and do not represent all deaths that occurred in that period.

    *Data during this period are incomplete because of the lag in time between when the death occurred and when the death certificate is completed, submitted to NCHS and processed for reporting purposes. This delay can range from 1 week to 8 weeks or more, depending on the jurisdiction, age, and cause of death.

    1Deaths with confirmed or presumed COVID-19, coded to ICD–10 code U07.1

    2Percent of expected deaths is the number of deaths for all causes for this week in 2020 compared to the average number across the same week in 2017–2019. Previous analyses of 2015–2016 provisional data completeness have found that completeness is lower in the first few weeks following the date of death (7).

    3Pneumonia death counts exclude pneumonia deaths involving influenza.
    Table 2. Deaths involving coronavirus disease 2019 (COVID-19) and pneumonia reported to NCHS by age group, United States. Week ending 2/1/2020 to 3/28/2020.*


    Data as of 4/3/2020
    All ages 1,150 446,778 86 24,741 469
    Under 1 year 0 2,396 63 19 0
    1–4 years 1 489 74 23 1
    5–14 years 0 713 71 26 0
    15–24 years 0 4,036 78 73 0
    25–34 years 8 8,424 83 189 3
    35–44 years 33 12,076 85 388 8
    45–54 years 75 23,299 77 983 26
    55–64 years 123 56,398 83 2,824 50
    65–74 years 265 87,567 88 4,778 91
    75–84 years 331 110,592 88 6,590 145
    85 years and over 314 140,788 84 8,848 145
    NOTE: Number of deaths reported in this table are the total number of deaths received and coded as of the date of analysis and do not represent all deaths that occurred in that period.

    *Data during this period are incomplete because of the lag in time between when the death occurred and when the death certificate is completed, submitted to NCHS and processed for reporting purposes. This delay can range from 1 week to 8 weeks or more, depending on the jurisdiction, age, and cause of death.

    1Deaths with confirmed or presumed COVID-19, coded to ICD–10 code U07.1.

    2Percent of expected deaths is the number of deaths for all causes for this week in 2020 compared to the average number across the same week in 2017–2019.

    3Pneumonia death counts exclude pneumonia deaths involving influenza.
    Table 3. Deaths involving coronavirus disease 2019 (COVID-19) and pneumonia reported to NCHS by jurisdiction of occurrence, United States. Week ending 2/1/2020 to 3/28/2020.*


    Data as of 4/3/2020
    United States 1,150 446,778 86 24,741 469
    Alabama 0 8,136 85 408 0
    Alaska 0 589 78 23 0
    Arizona 0 10,532 96 523 0
    Arkansas 0 5,390 92 269 0
    California 54 47,024 93 3,136 22
    Colorado 21 7,020 98 334 11
    Connecticut 0 0 0 0 0
    Delaware 0 1,115 65 50 0
    District of Columbia 0 924 84 58 0
    Florida 38 37,346 97 1,899 12
    Georgia 13 12,725 83 570 6
    Hawaii 0 1,904 90 118 0
    Idaho 1 2,389 93 110 1
    Illinois 9 18,762 96 1,155 4
    Indiana 0 10,635 87 599 0
    Iowa 0 5,007 90 295 0
    Kansas 3 4,441 89 240 1
    Kentucky 0 6,181 70 389 0
    Louisiana 44 6,801 82 258 18
    Maine 0 2,640 99 178 0
    Maryland 5 8,721 95 502 0
    Massachusetts 6 9,893 89 663 3
    Michigan 11 16,019 90 796 1
    Minnesota 4 7,613 95 407 2
    Mississippi 0 5,302 92 342 0
    Missouri 6 10,051 84 486 4
    Montana 0 1,491 79 66 0
    Nebraska 0 2,476 79 159 0
    Nevada 2 4,348 93 202 1
    New Hampshire 1 2,200 98 109 0
    New Jersey 43 13,210 96 694 24
    New Mexico 0 2,765 79 155 0
    New York4 180 17,731 96 1,343 98
    New York City 579 10,970 110 1,012 205
    North Carolina 0 3,060 18 151 0
    North Dakota 0 1,115 89 74 0
    Ohio 0 16,962 75 676 0
    Oklahoma 0 5,781 78 365 0
    Oregon 5 5,496 83 230 3
    Pennsylvania 19 17,692 70 880 10
    Rhode Island 0 1,494 78 50 0
    South Carolina 1 8,428 94 369 0
    South Dakota 1 1,281 86 70 0
    Tennessee 0 12,379 92 715 0
    Texas 6 32,459 84 1,825 2
    Utah 1 3,305 97 168 0
    Vermont 1 923 87 42 1
    Virginia 4 11,757 94 459 1
    Washington 92 9,805 93 561 39
    West Virginia 0 2,563 62 140 0
    Wisconsin 0 9,200 96 376 0
    Wyoming 0 727 89 42 0
    NOTE: Number of deaths reported in this table are the total number of deaths received and coded as of the date of analysis and do not represent all deaths that occurred in that period.

    *Data during this period are incomplete because of the lag in time between when the death occurred and when the death certificate is completed, submitted to NCHS and processed for reporting purposes. This delay can range from 1 week to 8 weeks or more, depending on the jurisdiction, age, and cause of death.

    1Deaths with confirmed or presumed COVID-19, coded to ICD–10 code U07.1.

    2Percent of expected deaths is the number of deaths for all causes for this week in 2020 compared to the average number across the same week in 2017–2019.

    3Pneumonia death counts exclude pneumonia deaths involving influenza.

    4Excludes New York City.
    Technical Notes



    Comparing data in this report to other sources


    Provisional death counts in this report will not match counts in other sources, such as media reports or numbers from county health departments. Death data, once received and processed by National Center for Health Statistics (NCHS), are tabulated by the state or jurisdiction in which the death occurred. Death counts are not tabulated by the decedent’s state of residence. COVID-19 deaths may also be classified or defined differently in various reporting and surveillance systems. Death counts in this report include laboratory confirmed COVID-19 deaths and clinically confirmed COVID-19 deaths. This includes deaths where COVID-19 is listed as a “presumed” or “probable” cause. Some local and state health departments only report laboratory-confirmed COVID deaths. This may partly account for differences between NCHS reported death counts and death counts reported in other sources. Provisional counts reported here track approximately 1–2 weeks behind other published data sources on the number of COVID-19 deaths in the U.S. (1,2,3).
    Nature and sources of data


    Provisional death counts are based on death records received and processed by NCHS as of a specified cutoff date. National provisional counts include deaths occurring within the 50 states and the District of Columbia. NCHS receives the death records from state vital registration offices through the Vital Statistics Cooperative Program. Provisional data are based on available records that meet certain data quality criteria at the time of analysis and may not include all deaths that occurred during a given time period especially for more recent periods. Estimates of completeness are provided. Therefore, they should not be considered comparable with final data and are subject to change.
    Cause-of-death classification and definition of deaths


    Mortality statistics are compiled in accordance with World Health Organization (WHO) regulations specifying that WHO member nations classify and code causes of death with the current revision of the International Statistical Classification of Diseases and Related Health Problems (ICD). ICD provides the basic guidance used in virtually all countries to code and classify causes of death. It provides not only disease, injury, and poisoning categories but also the rules used to select the single underlying cause of death for tabulation from the several diagnoses that may be reported on a single death certificate, as well as definitions, tabulation lists, the format of the death certificate, and regulations on use of the classification. Causes of death for data presented in this report were coded according to ICD guidelines described in annual issues of Part 2a of the NCHS Instruction Manual (4).

    Coronavirus disease deaths are identified using the ICD–10 code U07.1. Deaths are coded to U07.1 when coronavirus disease 2019 or COVID-19 are reported as a cause that contributed to death on the death certificate. These can include laboratory confirmed cases, as well as cases without laboratory confirmation. If the certifier suspects COVID-19 or determines it was likely (e.g., the circumstances were compelling within a reasonable degree of certainty), they can report COVID-19 as “probable” or “presumed” on the death certificate (5).

    Pneumonia deaths are identified using underlying cause-of-death codes from the 10th Revision of ICD (ICD–10): J12–J18, excluding deaths that involve influenza (J08–J11).
    Estimated completeness of data


    Provisional data are incomplete, and the level of completeness varies by jurisdiction, week, decedent’s age, and cause of death. Until data for a calendar year are finalized, typically in December of the following year, completeness of provisional data cannot be determined. However, completeness can be estimated in a variety of ways. Surveillance systems that rely on weekly monitoring of provisional mortality data, such as CDC’s FluView Interactive mortality surveillance (6), estimate completeness by comparing the count of deaths in a given week of the current year to the average count of deaths in that same week of the previous 3 years. These estimates can be generated for specific causes of death, jurisdictions, and age groups, and updated on a weekly or daily basis. For the purposes of COVID-19 surveillance, completeness is approximated by comparing the provisional number of deaths received to the number of expected deaths based on prior years data. Percent of expected deaths provided in this data release are based on the total count of deaths in the most recent weeks of the current year, compared with an average across the same weeks of the three previous years (i.e., 2017–2019). These estimates of completeness are calculated by week, jurisdiction of occurrence, and age group.

    It is important to note that the true levels of completeness are unknown, and the estimates provided here are only a proxy. In cases where mortality rates are increasing rapidly, particularly when excess deaths due to a novel cause are occurring, values for completeness for recent weeks may exceed 100% even when NCHS has yet to receive all available data. Conversely, if the number of deaths was elevated in prior years due to a severe flu season, for example, estimated completeness in the most recent weeks may be lower than the true value. To avoid relying too heavily on comparisons to a single week of a single prior year, estimates of completeness included in this release are based on the average counts in a given week across 3 prior years (e.g., the 12th week of 2017, 2018, and 2019).

    Percent of expected deaths provided in this release are shown to provide context for interpreting provisional counts of COVID-19 deaths and deaths due to related causes. Where estimated values are high (e.g., greater than 100%), this suggests that mortality is higher in 2020 relative to the same weeks of prior years. Where estimated values of completeness are low, this could indicate that data are incomplete due to delayed reporting, or that mortality is lower in 2020 compared with prior years, or some combination of these factors.
    Delays in reporting


    Provisional counts of deaths are underestimated relative to final counts. This is due to the many steps involved in reporting death certificate data. When a death occurs, a certifier (e.g. physician, medical examiner or coroner) will complete the death certificate with the underlying cause of death and any contributing causes of death. In some cases, laboratory tests or autopsy results may be required to determine the cause of death. Completed death certificate are sent to the state vital records office and then to NCHS for cause of death coding. At NCHS, about 80% of deaths are automatically processed and coded within seconds, but 20% of deaths need to manually coded, or coded by a person. Deaths involving certain conditions such as influenza and pneumonia are more likely to require manual coding than other causes of death. Furthermore, all deaths with COVID-19 are manually coded. Death certificates are typically manually coded within 7 days of receipt, although the coding delay can grow if there is a large increase in the number of deaths. As a result, underestimation of the number of deaths may be greater for certain causes of death than others.

    Previous analyses of provisional data completeness from 2015 suggested that mortality data is approximately 27% complete within 2 weeks, 54% complete within 4 weeks, and at least 75% complete within 8 weeks of when the death occurred (7). Pneumonia deaths are 26% complete within 2 weeks, 52% complete within 4 weeks, and 72% complete within 8 weeks (unpublished). Data timeliness has improved in recent years, and current timeliness is likely higher than published rates.
    Comparing deaths from different states


    Death counts should not be compared across states. Data timeliness varies by state. Some states report deaths on a daily basis, while other states report deaths weekly or monthly. Furthermore, health departments and state vital record offices may be affected by COVID-19 related response activities, which could further delay death certificate reporting. Currently, 63% of U.S. deaths are reported within 10 days of the date of death, but there is variation within states. Twenty states report over 75% of deaths within the first 10 days, while three states report fewer than 1% of deaths within 10 days.
    Why are pneumonia deaths included in this report?


    Pneumonia deaths are included to provide context for understanding the completeness of COVID-19 mortality data and related trends. Deaths due to COVID-19 may be misclassified as pneumonia deaths in the absence of positive test results, and pneumonia may appear on death certificates as a comorbid condition. Thus, increases in pneumonia deaths may be an indicator of excess COVID-19-related mortality. Additionally, estimates of completeness for pneumonia deaths may provide context for understanding the lag in reporting for COVID-19 deaths, as it is anticipated that these causes would have similar delays in reporting, processing, and coding.
    Source


    NCHS, National Vital Statistics System. Estimates are based on provisional data.
    References
    1. Dong E, Du H, Gardner L. An interactive web-based dashboard to track COVID-19 in real time. Lancet Infect Dis. 2020. Available from: https://doi.org/10.1016/S1473-3099(20)30120-1.external icon
    2. Wu J, McCann A, Collins K, Harris R, Huang J, Almukhtar S. Coronavirus in the U.S.: Latest map and case count. New York Times. https://www.nytimes.com/interactive/2020/us/coronavirus-us-cases.html.external icon
    3. National Center for Immunization and Respiratory Diseases (NCIRD), Division of Viral Diseases. Cases in the US. Centers for Disease Control and Prevention. 2020.
    4. National Vital Statistics System. Instructions for classifying the underlying cause of death. In: NCHS instruction manual; Part 2a. Published annually.
    5. World Health Organization. Emergency use ICD codes for COVID-19 disease outbreak. Available from: http://www9.who.int/classifications/icd/covid19/en/.external icon
    6. National Center for Immunization and Respiratory Diseases (NCIRD). CDC’s FluView Interactive. Centers for Disease Control and Prevention. Available from: https://www.cdc.gov/flu/weekly/index.htm.
    7. Spencer MR, Ahmad F. Timeliness of death certificate data for mortality surveillance and provisional estimates. National Center for Health Statistics. 2016.

    Page last reviewed: April 3, 2020
    Content source: CDC/National Center for Health StatisticsNational Vital Statistics SystemRelated Siteshttps://www.cdc.gov/nchs/nvss/vsrr/COVID19/index.htm
    Twitter: @RonanKelly13
    The views expressed are mine alone and do not represent the views of my employer or any other person or organization.

    Comment


    • #3
      Provisional Death Counts for Coronavirus Disease (COVID-19)


      alert icon

      Note: Provisional death counts are based on death certificate data received and coded by the National Center for Health Statistics as of April 10, 2020. Death counts are delayed and may differ from other published sources (see Technical Notes). Counts will be updated periodically. Additional information will be added to this site as available.



      The provisional counts for coronavirus disease (COVID-19) deaths are based on a current flow of mortality data in the National Vital Statistics System. National provisional counts include deaths occurring within the 50 states and the District of Columbia that have been received and coded as of the date specified. It is important to note that it can take several weeks for death records to be submitted to National Center for Health Statistics (NCHS), processed, coded, and tabulated. Therefore, the data shown on this page may be incomplete, and will likely not include all deaths that occurred during a given time period, especially for the more recent time periods. Death counts for earlier weeks are continually revised and may increase or decrease as new and updated death certificate data are received from the states by NCHS. COVID-19 death counts shown here may differ from other published sources, as data currently are lagged by an average of 1–2 weeks.

      The provisional data presented on this page include the weekly provisional count of deaths in the United States due to COVID-19, deaths from all causes and percent of expected deaths (i.e., number of deaths received over number of deaths expected based on data from previous years), pneumonia deaths (excluding pneumonia deaths involving influenza), pneumonia deaths, and influenza deaths involving COVID-19; (a) by week ending date, (b) by age at death, (c) by sex, and (d) by specific jurisdictions. Future updates to this release may include additional detail such as demographic characteristics, additional causes of death (e.g., acute respiratory distress syndrome or other comorbidities), or estimates based on models that account for reporting delays to generate more accurate predicted provisional counts.

      Pneumonia and influenza deaths are included to provide context for understanding the completeness of COVID-19 mortality data and related trends. Deaths due to COVID-19 may be misclassified as pneumonia or influenza deaths in the absence of positive test results, and these conditions may appear on death certificates as a comorbid condition. Thus, increases in pneumonia or influenza deaths may be an indicator of excess COVID-19-related mortality. Additionally, estimates of completeness for influenza or pneumonia deaths may provide context for understanding the lag in reporting for COVID-19 deaths, as it is anticipated that these causes would have similar delays in reporting, processing, and coding. However, it is possible that reporting of COVID-19 mortality may be slower or faster than for other causes of death, and that the delay may change over time. Analyses to better understand and quantify reporting delays for COVID-19 deaths and related causes are underway. The list of causes provided in these tables may expand in future releases as more data are received, and other potentially comorbid conditions are determined.
      Download Datasets

      Table 1. Deaths involving coronavirus disease 2019 (COVID-19), pneumonia, and influenza reported to NCHS by week ending date, United States. Week ending 2/1/2020 to 4/4/2020.*


      Data as of April 10, 2020
      Click image for larger version

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      NOTE: Number of deaths reported in this table are the total number of deaths received and coded as of the date of analysis and do not represent all deaths that occurred in that period.

      *Data during this period are incomplete because of the lag in time between when the death occurred and when the death certificate is completed, submitted to NCHS and processed for reporting purposes. This delay can range from 1 week to 8 weeks or more, depending on the jurisdiction, age, and cause of death.

      1Deaths with confirmed or presumed COVID-19, coded to ICD–10 code U07.1

      2Percent of expected deaths is the number of deaths for all causes for this week in 2020 compared to the average number across the same week in 2017–2019. Previous analyses of 2015–2016 provisional data completeness have found that completeness is lower in the first few weeks following the date of death (8).

      3Pneumonia death counts exclude pneumonia deaths involving influenza.

      4Influenza death counts include deaths with pneumonia or COVID-19 also listed as a cause of death.

      5Population is based on 2018 postcensal estimates from the U.S. Census Bureau (9)


      Table 2. Deaths involving coronavirus disease 2019 (COVID-19), pneumonia, and influenza reported to NCHS by age group, United States. Week ending 2/1/2020 to 4/4/2020.*


      Data as of April 10, 2020
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      NOTE: Number of deaths reported in this table are the total number of deaths received and coded as of the date of analysis and do not represent all deaths that occurred in that period.

      *Data during this period are incomplete because of the lag in time between when the death occurred and when the death certificate is completed, submitted to NCHS and processed for reporting purposes. This delay can range from 1 week to 8 weeks or more, depending on the jurisdiction, age, and cause of death.

      1Deaths with confirmed or presumed COVID-19, coded to ICD–10 code U07.1.

      2Percent of expected deaths is the number of deaths for all causes for this week in 2020 compared to the average number across the same week in 2017–2019.

      3Pneumonia death counts exclude pneumonia deaths involving influenza.

      4Influenza death counts include deaths with pneumonia or COVID-19 also listed as a cause of death.

      5Population is based on 2018 postcensal estimates from the U.S. Census Bureau (9)


      Table 3. Deaths involving coronavirus disease 2019 (COVID-19), pneumonia, and influenza reported to NCHS by sex, United States. Week ending 2/1/2020 to 4/4/2020.*


      Data as of April 10, 2020
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      NOTE: Number of deaths reported in this table are the total number of deaths received and coded as of the date of analysis and do not represent all deaths that occurred in that period.

      *Data during this period are incomplete because of the lag in time between when the death occurred and when the death certificate is completed, submitted to NCHS and processed for reporting purposes. This delay can range from 1 week to 8 weeks or more, depending on the jurisdiction, age, and cause of death.

      1Deaths with confirmed or presumed COVID-19, coded to ICD–10 code U07.1.

      2Percent of expected deaths is the number of deaths for all causes for this week in 2020 compared to the average number across the same week in 2017–2019.

      3Pneumonia death counts exclude pneumonia deaths involving influenza.

      4Influenza death counts include deaths with pneumonia or COVID-19 also listed as a cause of death.


      Table 4. Deaths involving coronavirus disease 2019 (COVID-19), pneumonia, and influenza reported to NCHS by jurisdiction of occurrence, United States. Week ending 2/1/2020 to 4/4/2020.*


      Data as of April 10, 2020
      Click image for larger version

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      NOTE: Number of deaths reported in this table are the total number of deaths received and coded as of the date of analysis and do not represent all deaths that occurred in that period.

      *Data during this period are incomplete because of the lag in time between when the death occurred and when the death certificate is completed, submitted to NCHS and processed for reporting purposes. This delay can range from 1 week to 8 weeks or more, depending on the jurisdiction, age, and cause of death.

      1Deaths with confirmed or presumed COVID-19, coded to ICD–10 code U07.1.

      2Percent of expected deaths is the number of deaths for all causes for this week in 2020 compared to the average number across the same week in 2017–2019.

      3Pneumonia death counts exclude pneumonia deaths involving influenza.

      4Influenza death counts include deaths with pneumonia or COVID-19 also listed as a cause of death.

      5United States death count includes the 50 states, plus the District of Columbia and New York City.

      6Excludes New York City.
      Technical Notes



      Comparing data in this report to other sources


      Provisional death counts in this report will not match counts in other sources, such as media reports or numbers from county health departments. Death data, once received and processed by National Center for Health Statistics (NCHS), are tabulated by the state or jurisdiction in which the death occurred. Death counts are not tabulated by the decedent’s state of residence. COVID-19 deaths may also be classified or defined differently in various reporting and surveillance systems. Death counts in this report include laboratory confirmed COVID-19 deaths and clinically confirmed COVID-19 deaths. This includes deaths where COVID-19 is listed as a “presumed” or “probable” cause. Some local and state health departments only report laboratory-confirmed COVID deaths. This may partly account for differences between NCHS reported death counts and death counts reported in other sources. Provisional counts reported here track approximately 1–2 weeks behind other published data sources on the number of COVID-19 deaths in the U.S. (1,2,3).
      Nature and sources of data


      Provisional death counts are based on death records received and processed by NCHS as of a specified cutoff date. National provisional counts include deaths occurring within the 50 states and the District of Columbia. NCHS receives the death records from state vital registration offices through the Vital Statistics Cooperative Program. Provisional data are based on available records that meet certain data quality criteria at the time of analysis and may not include all deaths that occurred during a given time period especially for more recent periods. Estimates of completeness are provided. Therefore, they should not be considered comparable with final data and are subject to change.
      Cause-of-death classification and definition of deaths


      Mortality statistics are compiled in accordance with World Health Organization (WHO) regulations specifying that WHO member nations classify and code causes of death with the current revision of the International Statistical Classification of Diseases and Related Health Problems (ICD). ICD provides the basic guidance used in virtually all countries to code and classify causes of death. It provides not only disease, injury, and poisoning categories but also the rules used to select the single underlying cause of death for tabulation from the several diagnoses that may be reported on a single death certificate, as well as definitions, tabulation lists, the format of the death certificate, and regulations on use of the classification. Causes of death for data presented in this report were coded according to ICD guidelines described in annual issues of Part 2a of the NCHS Instruction Manual (4).

      Coronavirus disease deaths are identified using the ICD–10 code U07.1. Deaths are coded to U07.1 when coronavirus disease 2019 or COVID-19 are reported as a cause that contributed to death on the death certificate. These can include laboratory confirmed cases, as well as cases without laboratory confirmation. If the certifier suspects COVID-19 or determines it was likely (e.g., the circumstances were compelling within a reasonable degree of certainty), they can report COVID-19 as “probable” or “presumed” on the death certificate (5, 6).

      Pneumonia deaths are identified using underlying cause-of-death codes from the 10th Revision of ICD (ICD–10): J12–J18, excluding deaths that involve influenza (J09–J11). Influenza deaths are identified from the ICD–10 codes J09–J11, and include deaths with pneumonia or COVID-19 listed as a contributing cause of death.
      Estimated completeness of data


      Provisional data are incomplete, and the level of completeness varies by jurisdiction, week, decedent’s age, and cause of death. Until data for a calendar year are finalized, typically in December of the following year, completeness of provisional data cannot be determined. However, completeness can be estimated in a variety of ways. Surveillance systems that rely on weekly monitoring of provisional mortality data, such as CDC’s FluView Interactive mortality surveillance (7), estimate completeness by comparing the count of deaths in a given week of the current year to the average count of deaths in that same week of the previous 3 years. These estimates can be generated for specific causes of death, jurisdictions, and age groups, and updated on a weekly or daily basis. For the purposes of COVID-19 surveillance, completeness is approximated by comparing the provisional number of deaths received to the number of expected deaths based on prior years data. Percent of expected deaths provided in this data release are based on the total count of deaths in the most recent weeks of the current year, compared with an average across the same weeks of the three previous years (i.e., 2017–2019). These estimates of completeness are calculated by week, jurisdiction of occurrence, and age group.

      It is important to note that the true levels of completeness are unknown, and the estimates provided here are only a proxy. In cases where mortality rates are increasing rapidly, particularly when excess deaths due to a novel cause are occurring, values for completeness for recent weeks may exceed 100% even when NCHS has yet to receive all available data. Conversely, if the number of deaths was elevated in prior years due to a severe flu season, for example, estimated completeness in the most recent weeks may be lower than the true value. To avoid relying too heavily on comparisons to a single week of a single prior year, estimates of completeness included in this release are based on the average counts in a given week across 3 prior years (e.g., the 12th week of 2017, 2018, and 2019).

      Percent of expected deaths provided in this release are shown to provide context for interpreting provisional counts of COVID-19 deaths and deaths due to related causes. Where estimated values are high (e.g., greater than 100%), this suggests that mortality is higher in 2020 relative to the same weeks of prior years. Where estimated values of completeness are low, this could indicate that data are incomplete due to delayed reporting, or that mortality is lower in 2020 compared with prior years, or some combination of these factors.
      Delays in reporting


      Provisional counts of deaths are underestimated relative to final counts. This is due to the many steps involved in reporting death certificate data. When a death occurs, a certifier (e.g. physician, medical examiner or coroner) will complete the death certificate with the underlying cause of death and any contributing causes of death. In some cases, laboratory tests or autopsy results may be required to determine the cause of death. Completed death certificate are sent to the state vital records office and then to NCHS for cause of death coding. At NCHS, about 80% of deaths are automatically processed and coded within seconds, but 20% of deaths need to manually coded, or coded by a person. Deaths involving certain conditions such as influenza and pneumonia are more likely to require manual coding than other causes of death. Furthermore, all deaths with COVID-19 are manually coded. Death certificates are typically manually coded within 7 days of receipt, although the coding delay can grow if there is a large increase in the number of deaths. As a result, underestimation of the number of deaths may be greater for certain causes of death than others.

      Previous analyses of provisional data completeness from 2015 suggested that mortality data is approximately 27% complete within 2 weeks, 54% complete within 4 weeks, and at least 75% complete within 8 weeks of when the death occurred (8). Pneumonia deaths are 26% complete within 2 weeks, 52% complete within 4 weeks, and 72% complete within 8 weeks (unpublished). Data timeliness has improved in recent years, and current timeliness is likely higher than published rates.
      Comparing deaths from different states


      Death counts should not be compared across states. Data timeliness varies by state. Some states report deaths on a daily basis, while other states report deaths weekly or monthly. Furthermore, health departments and state vital record offices may be affected by COVID-19 related response activities, which could further delay death certificate reporting. Currently, 63% of U.S. deaths are reported within 10 days of the date of death, but there is variation within states. Twenty states report over 75% of deaths within the first 10 days, while three states report fewer than 1% of deaths within 10 days.
      Why are pneumonia and influenza deaths included in this report?


      Pneumonia and influenza deaths are included to provide context for understanding the completeness of COVID-19 mortality data and related trends. Deaths due to COVID-19 may be misclassified as pneumonia or influenza deaths in the absence of positive test results, and pneumonia or influenza may appear on death certificates as a comorbid condition. Additionally, COVID-19 symptoms can be similar to influenza-like illness, thus deaths may be misclassified as influenza. Thus, increases in pneumonia and influenza deaths may be an indicator of excess COVID-19-related mortality. Additionally, estimates of completeness for pneumonia and influenza deaths may provide context for understanding the lag in reporting for COVID-19 deaths, as it is anticipated that these causes would have similar delays in reporting, processing, and coding.
      Source


      NCHS, National Vital Statistics System. Estimates are based on provisional data.
      References
      1. Dong E, Du H, Gardner L. An interactive web-based dashboard to track COVID-19 in real time. Lancet Infect Dis. 2020. Available from: https://doi.org/10.1016/S1473-3099(20)30120-1.external icon
      2. Wu J, McCann A, Collins K, Harris R, Huang J, Almukhtar S. Coronavirus in the U.S.: Latest map and case count. New York Times. https://www.nytimes.com/interactive/2020/us/coronavirus-us-cases.html.external icon
      3. National Center for Immunization and Respiratory Diseases (NCIRD), Division of Viral Diseases. Cases in the US. Centers for Disease Control and Prevention. 2020.
      4. National Vital Statistics System. Instructions for classifying the underlying cause of death. In: NCHS instruction manual; Part 2a. Published annually.
      5. National Center for Health Statistics. Guidance for certifying deaths due to COVID–19. Hyattsville, MD. 2020. Available from: https://www.cdc.gov/nchs/data/nvss/vsrg/vsrg03-508.pdf.pdf icon
      6. National Center for Health Statistics. New ICD code introduced for COVID-19 deaths. Hyattsville, MD. 2020. Available from: https://www.cdc.gov/nchs/data/nvss/coronavirus/Alert-2-New-ICD-code-introduced-for-COVID-19-deaths.pdfpdf icon
      7. National Center for Immunization and Respiratory Diseases (NCIRD). CDC’s FluView Interactive. Centers for Disease Control and Prevention. Available from: https://www.cdc.gov/flu/weekly/index.htm.
      8. Spencer MR, Ahmad F. Timeliness of death certificate data for mortality surveillance and provisional estimates. National Center for Health Statistics. 2016.
      9. U.S. Census Bureau. Annual estimates of the resident population by single year of age and sex for the United States: April 1, 2010 to July 1, 2018. Available from: https://factfinder.census.gov/faces/tableservices/jsf/pages/productview.xhtml?pid=PEP_2018_PEPSYASEXN&prodType =table.external icon

      Page last reviewed: April 10, 2020
      Content source: CDC/National Center for Health Statistics

      https://www.cdc.gov/nchs/nvss/vsrr/COVID19/index.htm
      Twitter: @RonanKelly13
      The views expressed are mine alone and do not represent the views of my employer or any other person or organization.

      Comment


      • #4

        Updated April 10, 2020

        Download Weekly Summary pdf icon[10 Pages, 2 MB]

        Key Updates for Week 14, ending April 4, 2020

        This CDC report provides a weekly summary and interpretation of key indicators that have been adapted to track the COVID-19 pandemic in the United States. While influenza-like-illness (ILI) declined, it is still elevated and laboratory confirmed COVID-19 activity continues to increase as do COVID-19 severity indicators (hospitalizations and deaths).

        Virus
        Public Health, Commercial and Clinical Laboratories
        Public health, commercial and clinical laboratories are all testing for SARS-CoV-2 and reporting their results. The national percentage of respiratory specimens testing positive for SARS-CoV-2 is increasing overall and for week 14 is distributed as follows:
        • 18.5% at public health laboratories, and
        • 7.7% at clinical laboratories.

        Since the start of the outbreak, 17.6 % of specimens tested at commercial laboratories have been positive for SARS-CoV-2.

        Outpatient and Emergency Department Visits
        Outpatient Influenza-Like Illness Network (ILINet) and National Syndromic Surveillance Program (NSSP)
        Two indicators from existing surveillance systems are being monitored to track outpatient or emergency department (ED) visits for potential COVID-19 illness.
        • Nationally, the percentages of visits for influenza-like illness (ILI) and COVID-19-like illness (CLI) are elevated compared to what is normally seen at this time but decreased compared to last week.

        Recent changes in health care seeking behavior are likely impacting both networks, making it difficult to draw further conclusions at this time. Tracking these systems moving forward will give additional insight into illness related to COVID-19.

        Severe Disease
        Hospitalizations
        Cumulative COVID-19-associated hospitalization rates since March 1, 2020, will be updated weekly. The overall cumulative hospitalization rate is 12.3 per 100,000, with the highest rates in persons 65 years and older (38.7 per 100,000) and 50-64 years (20.7 per 100,000).

        Mortality
        Based on death certificate data, the percentage of deaths attributed to COVID-19 increased from 4.0% during week 13 to 6.9% during week 14. The percentage of deaths due to pneumonia (excluding COVID-19 or influenza) decreased from 7.5% during week 13 to 7.2% during week 14.

        All data are preliminary and may change as more reports are received.

        A description of the surveillance systems summarized in COVIDView, including methodology and detailed descriptions of each data component, is available on the surveillance methods page.

        Key Points
        • CDC is modifying existing surveillance systems, many used to track influenza and other respiratory viruses annually, to track COVID-19.
        • Nationally, the percentage of laboratory specimens testing positive for SARS-CoV-2 continued to increase.
        • Visits to outpatient providers and emergency departments (EDs) for illnesses with symptoms consistent with COVID-19 are elevated compared to what is normally seen at this time of year but decreased compared to levels reported last week. At this time, there is little influenza virus circulation so the elevated proportion of people presenting with these symptoms is likely due to COVID-19, but may be tempered by a number of factors including less ILI overall because of widespread adoption of social distancing efforts as well as changes in healthcare seeking practices.
        • The overall cumulative COVID-19 associated hospitalization rate is 12.3 per 100,000, with the highest rates in persons 65 years and older (38.7 per 100,000) and 50-64 years (20.7 per 100,000). Hospitalization rates for COVID-19 in older people are higher than what is typically seen early in a flu season.
        • Based on death certificate data, the percentage of deaths attributed to COVID-19 increased from 4.0% during week 13 to 6.9% during week 14. The percentage of deaths due to pneumonia (excluding COVID-19 or influenza) decreased from 7.5% during week 13 to 7.2% during week 14.


        U.S. Virologic Surveillance

        The number of specimens tested for SARS-CoV-2 and reported to CDC by public health laboratories and a subset of clinical and commercial laboratories in the United States are summarized below. At this point in the outbreak, all laboratories are performing primary diagnostic functions; therefore, the percentage of specimens testing positive across laboratory types can be used to monitor trends in COVID-19 activity. As the outbreak progresses, it is possible that different types of laboratories will take on different roles, and the data interpretation may need to be modified. The lower percentage of specimens testing positive in the clinical laboratories compared to the public health and commercial laboratories is likely due to the amount of COVID-19 activity in areas with reporting laboratories and a larger proportion of specimens from children.
        65,917 225,850
        36,468 95,137
        1,241,214
        12,177 (18.5%) 32,437 (14.4%)
        2,798 (7.7%) 7,095 (7.5%)
        218,454 (17.6%)
        * Commercial and clinical laboratory data represents select laboratories and does not capture all tests performed in the United States.
        Public Health Laboratories

        Data Table

        Clinical Laboratories

        Data Table


        Additional virologic surveillance information: Surveillance Methods

        Outpatient/Emergency Department Illness

        Two syndromic surveillance systems are being used to monitor trends in outpatient and emergency department visits that may be related to COVID-19. Each system monitors a slightly different syndrome, and together these systems provide a more comprehensive picture of mild to moderate COVID-19 illness than either would individually. Both systems are currently being affected by recent changes in health care seeking behavior, including increasing use of telemedicine and recommendations to limit emergency department (ED) visits to severe illness, as well as increased social distancing. These changes affect the numbers of people and their reasons for seeking care in the outpatient and ED settings.
        ILINet


        The U.S. Outpatient Influenza-like Illness Surveillance Network (ILINet) provides data on visits for influenza-like illness (ILI) (fever [≥100F] and cough and/or sore throat) to approximately 2,600 primary care providers, emergency departments and urgent care centers in all 50 states, Puerto Rico, the District of Columbia and the U.S. Virgin Islands. Mild COVID-19 illness presents with symptoms similar to ILI, so ILINet is being used to track trends of mild COVID-19 illness and allows for comparison with prior influenza seasons.

        Nationwide during week 14, 3.9% of patient visits reported through ILINet were due to ILI. This percentage is above the national baseline of 2.4%, but represents the second week of a decline after three weeks of increase beginning in early March. The percentage of visits for ILI decreased in all age groups. Nationally, laboratory confirmed influenza activity as reported by clinical laboratories decreased to levels usually seen in summer months which, along with changes in healthcare seeking behavior and the impact of social distancing, is likely driving the decrease in ILI activity.
        Overall Percentage of Visits for ILI | Age Group ILI Data


        * Age-group specific percentages should not be compared to the national baseline.

        On a regional levelexternal icon, the percentage of outpatient visits for ILI ranged from 2.4% to 10.0% during week 14; all regions reported a decreased percentage of outpatient visits for ILI compared to week 13 but remained above their regions-specific baselines.
        ILI Activity Levels


        Data collected in ILINet are used to produce a measure of ILI activity for all 50 states, Puerto Rico, the District of Columbia and New York City. The mean reported percentage of visits due to ILI for the current week is compared to the mean reported during non-influenza weeks, and the activity levels correspond to the number of standard deviations below, at or above the mean.

        The number of jurisdictions at each activity level during week 14 and the change compared to the previous week are summarized in the table below and shown in the following maps. The decreasing percentage of visits for ILI described above are reflected in this week’s ILI activity levels.
        Activity Level Number of Jurisdictions
        Week 14 (Week ending April 4, 2020) Compared to Previous Week
        Very High 8 -6
        High 13 -4
        Moderate 4 -1
        Low 12 +5
        Minimal 16 +6
        Insufficient Data* 1 No change




        The “very high” activity level was recently developed and will be reflected in other postings of the ILINet activity map when the map is updated on April 17, 2020.
        National Syndromic Surveillance Program (NSSP): Emergency Department (ED) Visits


        NSSP is a collaboration among CDC, federal partners, local and state health departments, and academic and private sector partners to collect, analyze and share electronic patient encounter data received from multiple health care settings. To track trends of potential COVID-19 visits, visits for COVID-19-like illness (CLI) (fever and cough or shortness of breath or difficulty breathing) and ILI to a subset of emergency departments in 47 states are being monitored.

        Nationwide during week 14, 4.4% of emergency department visits captured in NSSP were due to CLI and 3.5% were due to ILI. This is the second week of decline in percentage of visits for ILI and the first week of decline in percentage of visits for CLI. All 10 HHS regionsexternal icon experienced a decline in percentage of visits for ILI and CLI.
        Data Table


        Additional information about medically attended outpatient and emergency department visits for ILI and CLI: Surveillance Methods

        Hospitalizations

        The COVID-19-Associated Hospitalization Surveillance Network (COVID-NET) conducts population-based surveillance for laboratory-confirmed COVID-19-associated hospitalizations in select counties participating in the Emerging Infections Program (EIP) and Influenza Hospitalization Surveillance Project (IHSP) states. COVID-NET-estimated hospitalization rates will be updated weekly.

        A total of 4,001 laboratory-confirmed COVID-19-associated hospitalizations were reported by COVID-NET sites between March 1, 2020, and April 4, 2020. The overall cumulative hospitalization rate was 12.3 per 100,000 population, with the highest rates in those aged 65 years and older (38.7 per 100,000) followed by adults aged 50-64 years (20.7 per 100,000).



        Additional hospitalization surveillance information: Surveillance Methods | COVID-Net interactive data

        Mortality Surveillance

        The National Center for Health Statistics (NCHS) collects death certificate data from vital statistics offices for all deaths occurring in the United States. Based on death certificate data available on April 9, 2020, 6.9% of all deaths occurring during the week ending April 4, 2020 (week 14) had COVID-19 listed as a cause of death, 7.2% had pneumonia (excluding deaths involving COVID-19 or influenza) listed as a cause of death, and 0.6% had influenza listed as a cause of death. The weekly percentage of deaths due to COVID-19 has increased each week since the start of the COVID-19 outbreak in the United States. The percentage of deaths due to pneumonia (excluding deaths involving COVID-19 or influenza) decreased during week 14 compared to week 13.
        Data Table


        NCHS data are also used to monitor the percentage of death occurring in a given week that had pneumonia and/or influenza (P&I) listed as a cause of death. When the percentage of P&I deaths exceeds the epidemic threshold, that indicates that significantly more P&I deaths occurred than would be expected at that time of year. During the most recent week for which these data are available (week ending March 28, 2020), 10.0% of deaths were due to P&I. This percentage is above the epidemic threshold of 7.1% for that week. The increase in P&I percentage is being driven primarily by an increase in non-influenza pneumonia deaths due to COVID-19.



        Additional NCHS mortality surveillance information: Surveillance Methods | Provisional Death Counts for COVID-19

        View Page In:pdf icon 10 Pages, 2 MB
        Page last reviewed: April 10, 2020
        Content source: National Center for Immunization and Respiratory Diseases (NCIRD), Division of Viral DiseaseshomeCoronavirus Disease 2019 (COVID-19)email_03Get Email Updates

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        https://www.cdc.gov/coronavirus/2019...iew/index.html
        Twitter: @RonanKelly13
        The views expressed are mine alone and do not represent the views of my employer or any other person or organization.

        Comment


        • #5
          COVIDView Weekly Summary


          Print Page
          Updated April 17, 2020

          Download Weekly Summary pdf icon[10 Pages, 2 MB]

          Key Updates for Week 15, ending April 11, 2020

          This CDC report provides a weekly summary and interpretation of key indicators that have been adapted to track the COVID-19 pandemic in the United States. While influenza-like illness (ILI) declined, it is still elevated and laboratory confirmed COVID-19 activity continues to increase as do COVID-19 severity indicators (hospitalizations and deaths).

          Virus
          Public Health, Commercial and Clinical Laboratories
          Public health, commercial and clinical laboratories are all testing for SARS-CoV-2, the virus that causes COVID-19, and reporting their results. The national percentage of respiratory specimens testing positive for SARS-CoV-2 increased from week 14 to week 15 and is as follows:
          • Public health laboratories – increased from 17.3% during week 14 to 17.8% during week 15;
          • Clinical laboratories – increased from 10.6% during week 14 to 11.5% during week 15;
          • Commercial laboratories – increased from 20.6% during week 14 to 22.6% during week 15.

          Outpatient and Emergency Department Visits
          Outpatient Influenza-Like Illness Network (ILINet) and National Syndromic Surveillance Program (NSSP)
          Two indicators from existing surveillance systems are being monitored to track outpatient or emergency department (ED) visits for potential COVID-19 illness.
          • Nationally, the percentages of visits for influenza-like illness (ILI) and COVID-19-like illness (CLI) are elevated but decreased compared to last week.

          Recent changes in health care seeking behavior are likely impacting data from both networks, making it difficult to draw further conclusions at this time. Tracking these systems moving forward will give additional insight into illness related to COVID-19.

          Severe Disease
          Hospitalizations
          Cumulative COVID-19-associated hospitalization rates since March 1, 2020, are updated weekly. The overall cumulative hospitalization rate is 20.0 per 100,000, with the highest rates in persons 65 years and older (63.8 per 100,000) and 50-64 years (32.8 per 100,000).

          Mortality
          Based on death certificate data, the percentage of deaths attributed to COVID-19, pneumonia or influenza increased from 17.8% during week 14 to 18.8% during week 15.

          All data are preliminary and may change as more reports are received.

          A description of the surveillance systems summarized in COVIDView, including methodology and detailed descriptions of each data component, is available on the surveillance methods page.

          Key Points
          • CDC has modified existing surveillance systems, many used to track influenza and other respiratory viruses annually, to track COVID-19.
          • Nationally, the percentage of laboratory specimens testing positive for SARS-CoV-2 continued to increase.
          • Visits to outpatient providers and emergency departments (EDs) for illnesses with symptoms consistent with COVID-19 are elevated compared to what is normally seen at this time of year but decreased compared to levels reported last week. At this time, there is little influenza virus circulation. The levels of people presenting for care with these symptoms is likely due to COVID-19 but may be tempered by a number of factors including less ILI overall because of widespread adoption of social distancing efforts and changes in healthcare seeking behavior.
          • The overall cumulative COVID-19 associated hospitalization rate is 20.0 per 100,000, with the highest rates in persons 65 years and older (63.8 per 100,000) and 50-64 years (32.8 per 100,000). Hospitalization rates for COVID-19 in older people are higher than what is typically seen early in a flu season.
          • Based on death certificate data, the percentage of deaths attributed to COVID-19, pneumonia or influenza increased from 17.8% during week 14 to 18.8% during week 15.


          U.S. Virologic Surveillance

          The number of specimens tested for SARS-CoV-2 and reported to CDC by public health laboratories and a subset of clinical and commercial laboratories in the United States are summarized below. At this point in the outbreak, all laboratories are performing primary diagnostic functions; therefore, the percentage of specimens testing positive across laboratory types can be used to monitor trends in COVID-19 activity. As the outbreak progresses, it is possible that different types of laboratories will take on different roles, and the data interpretation may need to be modified. The lower percentage of specimens testing positive in the clinical laboratories compared to the public health and commercial laboratories is likely due to the amount of COVID-19 activity in areas with reporting laboratories and a larger proportion of specimens from children.

          Click image for larger version

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          Public Health Laboratories

          Data Table

          Clinical Laboratories

          Data Table

          Commercial Laboratories




          * Commercial laboratories began testing for SARS-CoV-2 in early March, but the number and geographic distribution of reporting commercial laboratories became stable enough to calculate a weekly percentage of specimens testing positive as of March 29, 2020.
          Data Table


          Additional virologic surveillance information: Surveillance Methods

          Outpatient/Emergency Department Illness

          Two syndromic surveillance systems are being used to monitor trends in outpatient and emergency department visits that may be related to COVID-19. Each system monitors a slightly different syndrome, and together these systems provide a more comprehensive picture of mild to moderate COVID-19 illness than either would individually. Both systems are currently being affected by recent changes in healthcare seeking behavior, including increasing use of telemedicine and recommendations to limit emergency department (ED) visits to severe illness, as well as increased social distancing. These changes affect the numbers of people and their reasons for seeking care in the outpatient and ED settings.
          ILINet


          The U.S. Outpatient Influenza-like Illness Surveillance Network (ILINet) provides data on visits for influenza-like illness (ILI) (fever [≥100F] and cough and/or sore throat) to approximately 2,600 primary care providers, emergency departments and urgent care centers in all 50 states, Puerto Rico, the District of Columbia and the U.S. Virgin Islands. Mild COVID-19 illness presents with symptoms similar to ILI, so ILINet is being used to track trends of mild to moderate COVID-19 illness and allows for comparison with prior influenza seasons.

          Nationwide during week 15, 2.9% of patient visits reported through ILINet were due to ILI. This percentage is above the national baseline of 2.4% but represents the third week of a decline after three weeks of increase beginning in early March. The percentage of visits for ILI decreased in all age groups. Nationally, laboratory confirmed influenza activity as reported by clinical laboratories decreased to levels usually seen in summer months which, along with changes in healthcare seeking behavior and the impact of social distancing, is likely driving the decrease in ILI activity.



          * Age-group specific percentages should not be compared to the national baseline.

          On a regional levelexternal icon, the percentage of outpatient visits for ILI ranged from 1.3% to 8.3% during week 15; all regions reported a decreased percentage of outpatient visits for ILI compared to week 14 and five regions are below their region-specific baselines.
          Overall Percentage of Visits for ILI | Age Group ILI Data

          ILI Activity Levels


          Data collected in ILINet are used to produce a measure of ILI activity for all 50 states, Puerto Rico, the District of Columbia and New York City. The mean reported percentage of visits due to ILI for the current week is compared to the mean reported during non-influenza weeks, and the activity levels correspond to the number of standard deviations below, at or above the mean.

          The number of jurisdictions at each activity level during week 15 and the change compared to the previous week are summarized in the table below and shown in the following maps. The decreasing percentage of visits for ILI described above are reflected in this week’s ILI activity levels.
          Activity Level Number of Jurisdictions
          Week 15
          (Week ending April 11, 2020)
          Compared to Previous Week
          Very High 2 -6
          High 10 -4
          Moderate 6 +2
          Low 11 -1
          Minimal 24 +9
          Insufficient Data* 1 No change




          *Data collected in ILINet may disproportionally represent certain populations within a state, and may not accurately depict the full picture of influenza activity for the whole state. Differences in the data presented here by CDC and independently by some state health departments likely represent differing levels of data completeness with data presented by the state likely being the more complete.
          National Syndromic Surveillance Program (NSSP): Emergency Department (ED) Visits


          NSSP is a collaboration among CDC, federal partners, local and state health departments and academic and private sector partners to collect, analyze and share electronic patient encounter data received from multiple healthcare settings. To track trends of potential COVID-19 visits, visits for COVID-19-like illness (CLI) (fever and cough or shortness of breath or difficulty breathing or presence of a coronavirus diagnosis code) and ILI to a subset of emergency departments in 47 states are being monitored. The coronavirus diagnosis code was added to the CLI definition this week after input from public health and community partners. This addition changed the magnitude of the percentage of visits for CLI but it did not change the trends.

          Nationwide during week 15, 5.6% of emergency department visits captured in NSSP were due to CLI and 2.5% were due to ILI. This is the third week of decline in percentage of visits for ILI and the second week of decline in percentage of visits for CLI. All 10 HHS regionsexternal icon experienced a decline in percentage of visits for ILI and CLI.
          Data Table


          Additional information about medically attended outpatient and emergency department visits for ILI and CLI: Surveillance Methods

          Hospitalizations

          The COVID-19-Associated Hospitalization Surveillance Network (COVID-NET) conducts population-based surveillance for laboratory-confirmed COVID-19-associated hospitalizations in select counties participating in the Emerging Infections Program (EIP) and Influenza Hospitalization Surveillance Project (IHSP) states. COVID-NET-estimated hospitalization rates will be updated weekly.

          A total of 6,485 laboratory-confirmed COVID-19-associated hospitalizations were reported by sites between March 1, 2020, and April 11, 2020. The overall cumulative hospitalization rate was 20 per 100,000 population with the highest rates among adults aged 65 years and older (63.8 per 100,000) followed by adults aged 50-64 years (32.8 per 100,000).



          Among 1,968 cases with information on race/ethnicity, 43.4% were non-Hispanic white, 32.0% were non-Hispanic black, 11.7% were Hispanic and 12.9% were other race, including unknown race.
          Overall 0-4

          years
          5-17

          years
          18-49 years 50-64 years 65+

          years
          N (%) N (%) N (%) N (%) N (%) N (%)
          Non-Hispanic White 854 (43.4) 3 (60.0) 3 (33.3) 136 (29.2) 239 (37.5) 473 (55.6)
          Non-Hispanic Black 630 (32.0) 0 (0.0) 6 (66.7) 158 (34.0) 229 (35.9) 237 (27.8)
          Hispanic 230 (11.7) 2 (40.0) 0 (0.0) 107 (23.0) 82 (12.9) 39 (4.6)
          Other 254 (12.9) 0 (0.0) 0 (0.0) 64 (13.8) 88 (13.8) 102 (12.0)
          Among 886 hospitalized adults with information on underlying medical conditions, 90% had at least one reported underlying medical condition; the most commonly reported were hypertension, obesity, chronic metabolic disease and cardiovascular disease. Among 7 hospitalized children with information on underlying medical conditions, 71.4% had at least one underlying medical condition; the most commonly reported was asthma.

          Additional hospitalization surveillance information: Surveillance Methods | Additional rate data | Additional demographic and clinical data

          Mortality Surveillance

          The National Center for Health Statistics (NCHS) collects death certificate data from vital statistics offices for all deaths occurring in the United States. Based on death certificate data available on April 16, 2020, 18.8% of all deaths occurring during the week ending April 11, 2020 (week 15) were due to pneumonia, influenza or COVID-19 (PIC). This percentage is above the epidemic threshold of 7.0% for week 15 and has been increasing sharply since the end of February.



          *Data during recent weeks are incomplete because of the lag in time between when the death occurred and when the death certificate is completed, submitted to NCHS and processed for reporting purposes.
          Data Table


          Additional NCHS mortality surveillance information: Surveillance Methods | Provisional Death Counts for COVID-19 | Provisional Death Counts for PICpdf icon

          View Page In:pdf icon 10 Pages, 2 MB
          Page last reviewed: April 17, 2020
          Content source: National Center for Immunization and Respiratory Diseases (NCIRD), Division of Viral Diseases

          https://www.cdc.gov/coronavirus/2019...iew/index.html
          Twitter: @RonanKelly13
          The views expressed are mine alone and do not represent the views of my employer or any other person or organization.

          Comment


          • #6
            COVIDView Weekly Summary


            Print Page
            Updated April 24, 2020

            Download Weekly Summary pdf icon[42 Pages, 2 MB]

            Key Updates for Week 16, ending April 18, 2020

            Levels of influenza-like illness (ILI) declined again and are below the national baseline but remain elevated in the northeast and northwest of the country. Levels of laboratory confirmed COVID-19 activity remained similar to, or decreased slightly, compared to last week. Mortality attributed to COVID-19 decreased compared to last week but remains significantly elevated and may increase as additional death certificates are counted.

            Virus
            Public Health, Commercial and Clinical Laboratories
            The national percentage of respiratory specimens testing positive for SARS-CoV-2 at public health, clinical and commercial laboratories remained similar to, or decreased slightly from, week 15 to week 16 and is as follows:
            • Public health laboratories – increased from 17.8% during week 15 to 18.8% during week 16;
            • Clinical laboratories – decreased from 11.3% during week 15 to 9.6% during week 16;
            • Commercial laboratories – decreased from 22.8% during week 15 to 19.7% during week 16.

            Outpatient and Emergency Department Visits
            Outpatient Influenza-Like Illness Network (ILINet) and National Syndromic Surveillance Program (NSSP)
            Two indicators from existing surveillance systems are being monitored to track outpatient or emergency department (ED) visits for potential COVID-19 illness.
            • Nationally, the percentages of visits for ILI and COVID-19-like illness (CLI) decreased compared to last week and levels of ILI are now below baseline.

            Recent changes in health care seeking behavior are likely impacting data from both networks, making it difficult to draw further conclusions at this time. Tracking these systems moving forward will give additional insight into illness related to COVID-19.

            Severe Disease
            Hospitalizations
            Cumulative COVID-19-associated hospitalization rates since March 1, 2020, are updated weekly. The overall cumulative hospitalization rate is 29.2 per 100,000, with the highest rates in people 65 years and older (95.5 per 100,000) and 50-64 years (47.2 per 100,000).

            Mortality
            Based on death certificate data, the percentage of deaths attributed to pneumonia, influenza or COVID-19 (PIC) decreased from 23.6% during week 15 to 18.6% during week 16 but remained significantly above baseline. This percentage may change as additional death certificates are processed.

            All data are preliminary and may change as more reports are received.

            A description of the surveillance systems summarized in COVIDView, including methodology and detailed descriptions of each data component, is available on the surveillance methods page.

            Key Points
            • Nationally, the percentage of laboratory specimens testing positive for SARS-CoV-2 remained similar to, or decreased, compared to last week.
            • Nationally, visits to outpatient providers and emergency departments (EDs) for illnesses with symptoms consistent with COVID-19 continued to decline and are below baseline in many areas of the country.
              • The decrease in the percentage of people presenting for care with these symptoms may be due to decline in COVID-19 but may be tempered by a number of factors including less ILI overall because of widespread adoption of social distancing efforts and changes in healthcare seeking behavior.
              • At this time, there is little influenza activity.
            • The overall cumulative COVID-19 associated hospitalization rate is 29.2 per 100,000, with the highest rates in persons 65 years and older (95.5 per 100,000) and 50-64 years (47.2 per 100,000). Hospitalization rates for COVID-19 in older people are higher than what is typically seen early in a flu season.
            • Based on death certificate data, the percentage of deaths attributed to pneumonia, influenza or COVID-19 (PIC) decreased from 23.6% during week 15 to 18.6% during week 16 but remained significantly above baseline. This is very elevated in the context of any influenza season. The percentage may change as additional death certificates are processed.
            • Declines in some key indicators used to track COVID-19 from one week to the next could change as additional data are received but also may be a result of widespread social distancing measures.


            U.S. Virologic Surveillance

            The number of specimens tested for SARS-CoV-2 and reported to CDC by public health laboratories and a subset of clinical and commercial laboratories in the United States are summarized below. At this point in the outbreak, all laboratories are performing primary diagnostic functions; therefore, the percentage of specimens testing positive across laboratory types can be used to monitor trends in COVID-19 activity. As the outbreak progresses, it is possible that different types of laboratories will take on different roles, and the data interpretation may need to be modified. The lower percentage of specimens testing positive in the clinical laboratories compared to the public health and commercial laboratories is likely due to the amount of COVID-19 activity in areas with reporting laboratories and a larger proportion of specimens from children.
            72,345 401,159
            47,983 213,427
            455,162 2,550,201
            13,636 (18.8%) 62,686 (15.6%)
            4,585 (9.6%) 20,555 (9.6%)
            89,482 (19.7%) 498,381 (19.5%)
            * Commercial and clinical laboratory data represents select laboratories and does not capture all tests performed in the United States.
            Public Health Laboratories


            resize iconView LargerData Table

            Clinical Laboratories


            resize iconView LargerData Table

            Commercial Laboratories


            resize iconView Larger


            * Commercial laboratories began testing for SARS-CoV-2 in early March, but the number and geographic distribution of reporting commercial laboratories became stable enough to calculate a weekly percentage of specimens testing positive as of March 29, 2020.
            Data Table


            Additional virologic surveillance information: Surveillance Methods


            Outpatient/Emergency Department Illness

            Two syndromic surveillance systems are being used to monitor trends in outpatient and emergency department visits that may be related to COVID-19. Each system monitors a slightly different syndrome, and together these systems provide a more comprehensive picture of mild to moderate COVID-19 illness than either would individually. Both systems are currently being affected by recent changes in healthcare seeking behavior, including increasing use of telemedicine and recommendations to limit emergency department (ED) visits to severe illness, as well as increased social distancing. These changes affect the numbers of people and their reasons for seeking care in the outpatient and ED settings.
            ILINet


            The U.S. Outpatient Influenza-like Illness Surveillance Network (ILINet) provides data on visits for influenza-like illness (ILI) (fever [≥100F] and cough and/or sore throat) to approximately 2,600 primary care providers, emergency departments and urgent care centers in all 50 states, Puerto Rico, the District of Columbia and the U.S. Virgin Islands. Mild COVID-19 illness presents with symptoms similar to ILI, so ILINet is being used to track trends of mild to moderate COVID-19 illness and allows for comparison with prior influenza seasons.

            Nationwide during week 16, 2.2% of patient visits reported through ILINet were due to ILI. This percentage is below the national baseline of 2.4% and represents the fourth week of a decline after three weeks of increase beginning in early March. The percentage of visits for ILI decreased in all age groups. Nationally, laboratory-confirmed influenza activity as reported by clinical laboratories has decreased to levels usually seen in summer months which, along with changes in healthcare seeking behavior and the impact of social distancing, is likely contributing to the decrease in ILI activity.

            resize iconView Larger


            * Age-group specific percentages should not be compared to the national baseline.

            On a regional levelexternal icon, the percentage of outpatient visits for ILI ranged from 1.1% to 5.4% during week 16; all regions reported a decreased percentage of outpatient visits for ILI compared to week 15 and six regions are below their region-specific baselines.
            Overall Percentage of Visits for ILI | Age Group ILI Data

            ILI Activity Levels


            Data collected in ILINet are used to produce a measure of ILI activity for all 50 states, Puerto Rico, the District of Columbia and New York City. The mean reported percentage of visits due to ILI for the current week is compared to the mean reported during non-influenza weeks, and the activity levels correspond to the number of standard deviations below, at or above the mean.

            The number of jurisdictions at each activity level during week 16 and the change compared to the previous week are summarized in the table below and shown in the following maps. The decreasing percentage of visits for ILI described above are reflected in this week’s ILI activity levels.
            Activity Level Number of Jurisdictions
            Week 16
            (Week ending April 18, 2020)
            Compared to Previous Week
            Very High 1 -1
            High 7 -3
            Moderate 3 -3
            Low 8 -1
            Minimal 34 +8
            Insufficient Data* 1 No change
            *Data collected in ILINet may disproportionally represent certain populations within a state, and may not accurately depict the full picture of influenza activity for the whole state. Differences in the data presented here by CDC and independently by some state health departments likely represent differing levels of data completeness with data presented by the state likely being the more complete.
            National Syndromic Surveillance Program (NSSP): Emergency Department (ED) Visits


            NSSP is a collaboration among CDC, federal partners, local and state health departments and academic and private sector partners to collect, analyze and share electronic patient encounter data received from multiple healthcare settings. To track trends of potential COVID-19 visits, visits for COVID-19-like illness (CLI) (fever and cough or shortness of breath or difficulty breathing or presence of a coronavirus diagnosis code) and ILI to a subset of emergency departments in 47 states are being monitored.

            Nationwide during week 16, 4.7% of emergency department visits captured in NSSP were due to CLI and 1.8% were due to ILI. This is the fourth week of decline in percentage of visits for ILI and the third week of stable or declining percentage of visits for CLI. All 10 HHS regionsexternal icon experienced a decline in percentage of visits for ILI and CLI.

            resize iconView LargerData Table


            Additional information about medically attended outpatient and emergency department visits for ILI and CLI: Surveillance Methods


            Hospitalizations

            The COVID-19-Associated Hospitalization Surveillance Network (COVID-NET) conducts population-based surveillance for laboratory-confirmed COVID-19-associated hospitalizations in select counties participating in the Emerging Infections Program (EIP) and Influenza Hospitalization Surveillance Project (IHSP) states. COVID-NET-estimated hospitalization rates will be updated weekly.

            A total of 9,483 laboratory-confirmed COVID-19-associated hospitalizations were reported by sites between March 1, 2020 and April 18, 2020. The overall cumulative hospitalization rate was 29.2 per 100,000 population. The highest rate of hospitalization is among adults aged ≥ 65 (95.5 per 100,000), followed by adults aged 50-64 years (47.2 per 100,000) and adults aged 18-49 years (14.3 per 100,000).

            resize iconView Larger


            Among 2,803 cases with information on race/ethnicity, 43.7% were non-Hispanic white, 31.4% were non-Hispanic black, 12.4% were Hispanic, and 12.6% were other race, including unknown race.
            Overall 0-4 years 5-17 years 18-49 years 50-64 years 65+ years
            N (%) N (%) N (%) N (%) N (%) N (%)
            Non-Hispanic White 1,224 (43.7) 3 (50.0) 2 (18.2) 173 (27.0) 334 (38.1) 712 (56.2)
            Non-Hispanic Black 879 (31.4) 0 (0.0) 6 (54.5) 211 (32.9) 305 (34.8) 357 (28.2)
            Hispanic 347 (12.4) 2 (33.3) 2 (18.2) 162 (25.3) 121 (13.8) 60 (4.7)
            Other 353 (12.6) 1 (16.7) 1 (9.1) 95 (14.8) 117 (13.3) 139 (11.0)
            Among 1,393 hospitalized adults with information on underlying medical conditions, 90.2% had at least one reported underlying medical condition, the most commonly reported were hypertension, obesity, chronic metabolic disease, and cardiovascular disease.

            resize iconView Larger


            Additional hospitalization surveillance information: Surveillance Methods | Additional rate data | Additional demographic and clinical data


            Mortality Surveillance

            The National Center for Health Statistics (NCHS) collects death certificate data from vital statistics offices for all deaths occurring in the United States. Based on death certificate data available on April 23, 2020, 18.6% of all deaths occurring during the week ending April 18, 2020 (week 16) were due to pneumonia, influenza or COVID-19 (PIC). This percentage is above the epidemic threshold of 6.9% for week 16 and represents the first week of a decline in PIC percentage since the end of February; however, data for week 16 are incomplete and the PIC percentage may increase as more death certificates are filed.

            resize iconView Larger


            *Data during recent weeks are incomplete because of the lag in time between when the death occurred and when the death certificate is completed, submitted to NCHS and processed for reporting purposes.
            Data Table


            Additional NCHS mortality surveillance information: Surveillance Methods | Provisional Death Counts for COVID-19

            View Page In:pdf icon 10 Pages, 2 MB
            Page last reviewed: April 24, 2020
            Content source: National Center for Immunization and Respiratory Diseases (NCIRD), Division of Viral Diseases

            https://www.cdc.gov/coronavirus/2019...iew/index.html
            Twitter: @RonanKelly13
            The views expressed are mine alone and do not represent the views of my employer or any other person or organization.

            Comment


            • #7
              COVIDView Weekly Summary


              Print Page
              Updated May 1, 2020

              Download Weekly Summary pdf icon[42 Pages, 2 MB]

              Key Updates for Week 17, ending April 25, 2020

              Nationally, levels of influenza-like illness (ILI) declined again this week. They have been below the national baseline for two weeks but remain elevated in the northeastern and northwestern part of the country. Levels of laboratory confirmed SARS-CoV-2 activity remained similar or decreased compared to last week. Mortality attributed to COVID-19 decreased compared to last week but remains significantly elevated and may increase as additional death certificates are counted.

              Virus
              Public Health, Commercial and Clinical Laboratories
              The national percentage of respiratory specimens testing positive for SARS-CoV-2 at public health, clinical and commercial laboratories remained similar or decreased from week 16 to week 17. Percentages by type of laboratory:
              • Public health laboratories – decreased from 19.4% during week 16 to 17.1% during week 17;
              • Clinical laboratories – remained similar with 10.9% during week 16 and 11.0% during week 17;
              • Commercial laboratories – decreased from 19.5% during week 16 to 16.4% during week 17.

              Outpatient and Emergency Department Visits
              Outpatient Influenza-Like Illness Network (ILINet) and National Syndromic Surveillance Program (NSSP)
              Two indicators from existing surveillance systems are being used to track outpatient or emergency department (ED) visits for illness with symptoms compatible with COVID-19.
              • Nationally, the percentages of visits for ILI and COVID-19-like illness (CLI) decreased compared to last week. Levels of ILI are now below baseline for the second week.

              Recent changes in health care seeking behavior are likely affecting data reported from both networks, making it difficult to draw further conclusions at this time. Tracking these systems moving forward will give additional insight into illness related to COVID-19.

              Severe Disease
              Hospitalizations
              Cumulative COVID-19-associated hospitalization rates since March 1, 2020, are updated weekly. The overall cumulative hospitalization rate is 40.4 per 100,000, with the highest rates in people 65 years and older (131.6 per 100,000) and 50-64 years (63.7 per 100,000).

              Mortality
              Based on death certificate data, the percentage of deaths attributed to pneumonia, influenza or COVID-19 (PIC) decreased from 23.6% during week 16 to 14.6% during week 17 but remained significantly above baseline. This is the second week of declines in this indicator, but this percentage may change as death certificates representing recent deaths are processed.

              All data are preliminary and may change as more reports are received.

              A description of the surveillance systems summarized in COVIDView, including methodology and detailed descriptions of each data component, is available on the surveillance methods page.

              Key Points
              • Nationally, the percentage of laboratory specimens testing positive for SARS-CoV-2 remained similar, or decreased, compared to last week.
              • Nationally, visits to outpatient providers and emergency departments (EDs) for illnesses with symptoms consistent with COVID-19 continued to decline and are below baseline nationally and in many regions of the country. They remain elevated in the northeast and northwest.
                • The decrease in the percentage of people presenting for care with ILI and CLI may be due to a decline in COVID-19 illness. Reported levels of activity may be decreasing because of widespread adoption of social distancing efforts and changes in healthcare seeking behavior.
                • Little influenza virus activity has been reported in recent weeks.
              • The overall cumulative COVID-19 associated hospitalization rate is 40.4 per 100,000, with the highest rates in people 65 years and older (131.6 per 100,000) and 50-64 years (63.7 per 100,000).
                • Hospitalization rates for COVID-19 in adults (18-64 years) are higher than hospitalization rates for influenza at comparable time points* during the past 5 influenza seasons.
                • For people 65 years and older, current COVID-19 hospitalization rates are similar to those observed during comparable time points* during recent high severity influenza seasons.
                • For children (0-17 years), COVID-19 hospitalization rates are much lower than influenza hospitalization rates during recent influenza seasons.
              • Based on death certificate data, the percentage of deaths attributed to pneumonia, influenza or COVID-19 (PIC) decreased from 23.6% during week 16 to 14.6% during week 17 which is still significantly above baseline. This is the second week of decline in this indicator, but the percentage remains high compared with any influenza season. The percentage may change as additional death certificates for deaths during recent weeks are processed.
              • Declines in some key indicators used to track COVID-19 from one week to the next could change as additional data are received but also may be a result of widespread social distancing measures.

              *Number of weeks since 10% of specimens tested positive for SARS-CoV-2 and influenza, respectively.
              ...
              https://www.cdc.gov/coronavirus/2019...iew/index.html
              Twitter: @RonanKelly13
              The views expressed are mine alone and do not represent the views of my employer or any other person or organization.

              Comment


              • #8
                COVIDView Weekly Summary


                Print Page
                Updated May 8, 2020

                Download Weekly Summary pdf icon[43 Pages, 2 MB]

                Key Updates for Week 18, ending May 2, 2020

                Nationally, levels of influenza-like illness (ILI) and COVID-19-like illness (CLI) and the percentage of specimens testing positive for SARS-CoV-2, the virus that causes COVID-19, continues to decline. Mortality attributed to COVID-19 also decreased compared to last week but remains elevated above baseline and may increase as additional death certificates are counted.

                Virus
                Public Health, Commercial and Clinical Laboratories
                The national percentage of respiratory specimens testing positive for SARS-CoV-2 at public health, clinical and commercial laboratories decreased from week 17 to week 18. Percentages by type of laboratory:
                • Public health laboratories – decreased from 17.7% during week 17 to 13.2% during week 18;
                • Clinical laboratories – decreased from 10.3% during week 17 to 9.0% during week 18;
                • Commercial laboratories – decreased from 15.9% during week 17 to 13.2% during week 18.

                Outpatient and Emergency Department Visits
                Outpatient Influenza-Like Illness Network (ILINet) and National Syndromic Surveillance Program (NSSP)
                Two indicators from existing surveillance systems are being used to track outpatient or emergency department (ED) visits for illness with symptoms compatible with COVID-19.
                • Nationally, the percentages of visits for ILI and COVID-19-like illness (CLI) decreased compared to last week. Levels of ILI are now below baseline nationally for the second week and in all 10 surveillance regions.

                Recent changes in health care seeking behavior, including increasing use of telemedicine, recommendations to limit emergency department (ED) visits to severe illnesses, and increased practice of social distancing, are likely affecting data reported from both networks, making it difficult to draw further conclusions at this time. Tracking these systems moving forward will give additional insight into illness related to COVID-19.

                Severe Disease
                Hospitalizations
                Cumulative COVID-19-associated hospitalization rates since March 1, 2020, are updated weekly. The overall cumulative hospitalization rate is 50.3 per 100,000, with the highest rates in people 65 years and older (162.2 per 100,000) and 50-64 years (79.0 per 100,000).

                Mortality
                Based on death certificate data, the percentage of deaths attributed to pneumonia, influenza or COVID-19 (PIC) decreased from 21.0% during week 17 to 10.6% during week 18 but remained above baseline. This is the third week of a stable or declining percentage of deaths due to PIC, but this percentage may change as death certificates representing recent deaths are processed.

                All data are preliminary and may change as more reports are received.

                A description of the surveillance systems summarized in COVIDView, including methodology and detailed descriptions of each data component, is available on the surveillance methods page.

                Key Points
                • Nationally, the percentages of laboratory specimens testing positive for SARS-CoV-2 decreased compared to last week.
                • Nationally, visits to outpatient providers and emergency departments (EDs) for illnesses with symptoms consistent with COVID-19 continued to decline and are below baseline nationally and in all regions of the country.
                  • The decrease in the percentage of people presenting for care with ILI and CLI may be due to a decline in COVID-19 illness, which could be in part a result of widespread adoption of social distancing in addition to changes in healthcare seeking behavior.
                  • There has been very little influenza virus activityin recent weeks.
                • The overall cumulative COVID-19 associated hospitalization rate is 50.3 per 100,000, with the highest rates in people aged 65 years and older (162.2 per 100,000) and 50-64 years (79.0 per 100,000). Hospitalization rates are cumulative and expected to increase as the COVID-19 pandemic continues.
                  • Hospitalization rates for COVID-19 in adults (18-64 years) are already higher than hospitalization rates for influenza at comparable time points* during the past 5 influenza seasons.
                  • For people 65 years and older, current COVID-19 hospitalization rates are within ranges observed during comparable time points* in recent influenza seasons.
                  • For children (0-17 years), COVID-19 hospitalization rates are much lower than influenza hospitalization rates during recent influenza seasons.
                • Based on death certificate data, the percentage of deaths attributed to pneumonia, influenza or COVID-19 (PIC) decreased from 21.0% during week 17 to 10.6% during week 18 but remained above baseline. This is the third week during which a declining percentage of deaths due to PIC has been seen, but the percentage remains high compared with any influenza season. The percentage may change as additional death certificates for deaths during recent weeks are processed.

                *Number of weeks since 10% of specimens tested positive for SARS-CoV-2 and influenza, respectively.
                ...
                https://www.cdc.gov/coronavirus/2019...iew/index.html
                Twitter: @RonanKelly13
                The views expressed are mine alone and do not represent the views of my employer or any other person or organization.

                Comment


                • #9
                  COVIDView: A Weekly Surveillance Summary of U.S. COVID-19 Activity


                  Print Page
                  Updated May 15, 2020

                  Download Weekly Summary pdf icon[46 Pages, 2 MB]
                  Key Updates for Week 19, ending May 9, 2020


                  Nationally, levels of influenza-like illness (ILI) and COVID-19-like illness (CLI) and the percentage of specimens testing positive for SARS-CoV-2, the virus that causes COVID-19, continue to decline. Mortality attributed to COVID-19 also decreased compared to last week but remains elevated above baseline and may increase as additional death certificates are counted.
                  Virus

                  Public Health, Commercial and Clinical Laboratories


                  The national percentage of respiratory specimens testing positive for SARS-CoV-2 at public health, clinical and commercial laboratories decreased from week 18 to week 19. Percentages by type of laboratory:
                  • Public health laboratories – decreased from 13.1% during week 18 to 11.8% during week 19;
                  • Clinical laboratories – decreased from 8.4% during week 18 to 6.9% during week 19;
                  • Commercial laboratories – decreased from 13.0% during week 18 to 10.2% during week 19.
                  Outpatient and Emergency Department Visits

                  Outpatient Influenza-Like Illness Network (ILINet) and National Syndromic Surveillance Program (NSSP)


                  Two indicators from existing surveillance systems are being used to track outpatient or emergency department (ED) visits for illness with symptoms compatible with COVID-19.
                  • Nationally, the percentages of visits for ILI and CLI decreased compared to last week. Levels of ILI are now below baseline nationally for the third week and in all 10 surveillance regions.

                  Recent changes in health care seeking behavior, including increasing use of telemedicine, recommendations to limit emergency department (ED) visits to severe illnesses, and increased practice of social distancing, are likely affecting data reported from both networks, making it difficult to draw further conclusions at this time. Tracking these systems moving forward will give additional insight into illness related to COVID-19.
                  Severe Disease

                  Hospitalizations


                  Cumulative COVID-19-associated hospitalization rates since March 1, 2020, are updated weekly. The overall cumulative hospitalization rate is 60.5 per 100,000, with the highest rates in people aged 65 years and older (192.4 per 100,000) and 50-64 years (94.4 per 100,000).
                  Mortality


                  Based on death certificate data, the percentage of deaths attributed to pneumonia, influenza or COVID-19 (PIC) decreased from 17.8% during week 18 to 12.8% during week 19 but remained above baseline. This is the third week of a declining percentage of deaths due to PIC, but this percentage may change as more death certificates are processed, particularly for recent weeks.

                  All data are preliminary and may change as more reports are received.

                  A description of the surveillance systems summarized in COVIDView, including methodology and detailed descriptions of each data component, is available on the surveillance methods page.
                  Key Points
                  • Nationally, the percentages of laboratory specimens testing positive for SARS-CoV-2 decreased compared to last week.
                    • While the number of specimens from children <18 years of age tested is low (<5% of all specimens tested in public health and commercial laboratories), the percentage of these testing positive for SARS-CoV-2 in this age group has either trended upward or remained relatively stable in recent weeks. Other age groups have seen declines in percent positivity during the same time period.
                  • Nationally, visits to outpatient providers and emergency departments (EDs) for illnesses with symptoms consistent with COVID-19 continued to decline. Outpatient ILI visits are below baseline nationally and in all regions of the country.
                    • The decrease in the percentage of people presenting for care with ILI and CLI may be due to a decline in COVID-19 illness, which could be in part a result of widespread adoption of social distancing in addition to changes in healthcare seeking behavior.
                    • There has been very little influenza virus activity in recent weeks.
                  • The overall cumulative COVID-19 associated hospitalization rate is 60.5 per 100,000, with the highest rates in people 65 years of age and older (192.4 per 100,000) and 50-64 years (94.4 per 100,000). Hospitalization rates are cumulative and will increase as the COVID-19 pandemic continues.
                    • Hospitalization rates for COVID-19 in adults (18-64 years) are already higher than hospitalization rates for influenza at comparable time points* during the past 5 influenza seasons.
                    • For people 65 years and older, current COVID-19 hospitalization rates are within ranges of influenza hospitalization rates observed at comparable time points* during recent influenza seasons.
                    • For children (0-17 years), COVID-19 hospitalization rates are much lower than influenza hospitalization rates at comparable time points* during recent influenza seasons.
                  • Based on death certificate data, the percentage of deaths attributed to pneumonia, influenza or COVID-19 (PIC) decreased from 17.8% during week 18 to 12.8% during week 19, but remained above baseline. This is the third week during which a declining percentage of deaths due to PIC has been seen, but the percentage remains high compared with any influenza season. The percentage may change as additional death certificates for deaths during recent weeks are processed.

                  *Number of weeks since 10% of specimens tested positive for SARS-CoV-2 and influenza, respectively.
                  National 10.2 Declining (5 weeks) 1.2 Below Declining (7 weeks) 2.8 Declining (5 weeks) 12.8 Above Declining (3 weeks)
                  Region 1 14.0 Declining (4 weeks) 1.4 Below Declining (7 weeks) 4.7 Declining (4 weeks) 24.2 Above Declining (2 weeks)
                  Region 2 13.9 Declining (5 weeks) 2.0 Below Declining (6 weeks) 3.8 Declining (5 weeks) 30.0 Above Declining (3 weeks)
                  Region 3 14.6 Declining (3 weeks) 1.4 Below Declining (7 weeks) 4.0 Declining (4 weeks) 13.1 Above Declining (3 weeks)
                  Region 4 6.6 Declining (6 weeks) 0.9 Below Declining (7 weeks) 1.8 Declining (6 weeks) 7.2 Above Declining (4 weeks)
                  Region 5 10.8 Declining (2 weeks) 1.2 Below Declining (7 weeks) 3.7 Declining (5 weeks) 9.2 Above Declining (3 weeks)
                  Region 6 7.1 Declining (5 weeks) 1.4 Below Declining (7 weeks) 2.1 Declining (6 weeks) 7.4 Above Declining (4 weeks)
                  Region 7 12.0 Declining (2 weeks) 0.6 Below Declining (1 week) 1.6 Declining (7 weeks) 9.1 Above Declining (3 weeks)
                  Region 8 7.2 Increasing (1 week) 0.8 Below Declining (8 weeks) 3.0 Declining (6 weeks) 5.0 Below Declining (2 weeks)
                  Region 9 7.3 Declining (3 weeks) 1.2 Below No change 2.5 Declining (7 weeks) 7.4 Above Declining (3 weeks)
                  Region 10 5.0 Declining (3 weeks) 1.1 Below Declining (7 weeks) 1.6 Declining (7 weeks) Insufficient Data for Week 19
                  * Public health, clinical and commercial laboratory data combined.
                  U.S. Virologic Surveillance


                  The number of specimens tested for SARS-CoV-2 and reported to CDC by public health laboratories and a subset of clinical and commercial laboratories in the United States are summarized below. At this point in the outbreak, all laboratories are performing primary diagnostic functions; therefore, the percentage of specimens testing positive across laboratory types can be used to monitor trends in COVID-19 activity. As the outbreak progresses, it is possible that different types of laboratories will take on different roles, and the data interpretation may need to change. The lower percentage of specimens testing positive in clinical laboratories compared to public health and commercial laboratories may be influenced by COVID-19 activity in areas with reporting laboratories and by larger proportions of specimens obtained from children tested in these laboratories.
                  955,714 6,012,947
                  131,841 836,543
                  81,269 494,880
                  742,604 4,681,524
                  97,237 (10.1%) 945,395 (15.7%)
                  15,501 (11.8%) 124,473 (14.9%)
                  5,641 (6.9%) 45,312 (9.2%)
                  76,095 (10.2%) 775,610 (16.6%)
                  * Commercial and clinical laboratory data represents select laboratories and does not capture all tests performed in the United States.
                  Public Health Laboratories


                  resize iconView LargerView Data Table

                  Clinical Laboratories


                  resize iconView LargerView Data Table

                  Commercial Laboratories


                  resize iconView Larger


                  * Commercial laboratories began testing for SARS-CoV-2 in early March, but the number and geographic distribution of reporting commercial laboratories became stable enough to calculate a weekly percentage of specimens testing positive as of March 29, 2020.
                  View Data Table


                  Additional virologic surveillance information: Surveillance Methods


                  Outpatient/Emergency Department Illness


                  Two syndromic surveillance systems are being used to monitor trends in outpatient and emergency department visits that may be associated with COVID-19. Each system monitors a slightly different syndrome, and together these systems provide a more comprehensive picture of mild to moderate COVID-19 illness than either would individually. Both systems are currently being affected by recent changes in healthcare seeking behavior, including increased use of telemedicine, recommendations to limit emergency department (ED) visits to severe illnesses, and increased practice of social distancing. These changes affect the numbers of people and their reasons for seeking care in the outpatient and ED settings.
                  ILINet


                  The U.S. Outpatient Influenza-like Illness Surveillance Network (ILINet) provides data on visits for influenza-like illness (ILI) (fever [≥100F] and cough and/or sore throat) to approximately 2,600 primary care providers, emergency departments and urgent care centers in all 50 states, Puerto Rico, the District of Columbia and the U.S. Virgin Islands. Mild COVID-19 illness presents with symptoms similar to ILI, so ILINet is being used to track trends of mild to moderate COVID-19 illness and allows for comparison with prior influenza seasons.

                  Nationwide during week 19, 1.2% of patient visits reported through ILINet were due to ILI. This percentage is below the national baseline of 2.4% and represents the seventh week of decline after three weeks of increase beginning in early March. The percentage of visits for ILI decreased in all age groups. Nationally, laboratory-confirmed influenza activity as reported by clinical laboratories has decreased to levels usually seen in summer months which, along with changes in healthcare seeking behavior and the impact of social distancing, is likely contributing to the decrease in ILI activity.

                  resize iconView Larger


                  * Age-group specific percentages should not be compared to the national baseline.

                  On a regional levelexternal icon, the percentage of outpatient visits for ILI ranged from 0.6% to 2.0% during week 19. Compared to week 18, the percent of outpatient visits for ILI was unchanged in region 9, but decreased in all other regions, and all ten regions are below their region-specific baselines.
                  Overall Percentage of Visits for ILI | Age Group ILI Data

                  ILI Activity Levels


                  Data collected in ILINet are used to produce a measure of ILI activity for all 50 states, Puerto Rico, the District of Columbia and New York City. The mean reported percentage of visits due to ILI for the current week is compared to the mean reported during non-influenza weeks, and the activity levels correspond to the number of standard deviations below, at or above the mean.

                  The number of jurisdictions at each activity level during week 19 and the change compared to the previous week are summarized in the table below and shown in the following maps. The decreasing percentage of visits for ILI described above are reflected in this week’s ILI activity levels.
                  Activity Level Number of Jurisdictions
                  Week 19
                  (Week ending May 9, 2020)
                  Compared to Previous Week
                  Very High 0 No change
                  High 1 -1
                  Moderate 2 No change
                  Low 2 -2
                  Minimal 48 +3
                  Insufficient Data* 1 No change
                  *Data collected in ILINet may disproportionally represent certain populations within a state and may not accurately depict the full picture of influenza activity for the whole state. Differences in the data presented here by CDC and independently by some state health departments likely represent differing levels of data completeness with data presented by the state likely being the more complete.
                  National Syndromic Surveillance Program (NSSP): Emergency Department (ED) Visits


                  NSSP is a collaboration among CDC, federal partners, local and state health departments and academic and private sector partners to collect, analyze and share electronic patient encounter data received from multiple healthcare settings. To track trends of potential COVID-19 visits, visits for COVID-19-like illness (CLI) (fever and cough or shortness of breath or difficulty breathing or presence of a coronavirus diagnosis code) and ILI to a subset of emergency departments in 47 states are being monitored.

                  Nationwide during week 19, 2.8% of emergency department visits captured in NSSP were due to CLI and 0.9% were due to ILI. This is the seventh week of decline in percentage of visits for ILI and the sixth week of stable or declining percentage of visits for CLI. All 10 HHS regionsexternal icon experienced a decline in percentage of visits for ILI and CLI.

                  resize iconView LargerView Data Table


                  Additional information about medically attended outpatient and emergency department visits for ILI and CLI: Surveillance Methods


                  Hospitalizations


                  The COVID-19-Associated Hospitalization Surveillance Network (COVID-NET) conducts population-based surveillance for laboratory-confirmed COVID-19-associated hospitalizations in select counties participating in the Emerging Infections Program (EIP) and states participating in the Influenza Hospitalization Surveillance Project (IHSP). COVID-NET-estimated hospitalization rates are updated weekly.

                  A total of 19,637 laboratory-confirmed COVID-19-associated hospitalizations were reported by sites between March 1, 2020, and May 9, 2020. The overall cumulative hospitalization rate was 60.5 per 100,000 population. Among the 0-4 years, 5-17 years, 18-49 years, 50-64 years, and ≥ 65 years age groups, the highest rate of hospitalization is among adults aged 65 years (192.4 per 100,000), followed by adults aged 50-64 years (94.4 per 100,000) and adults aged 18-49 years (32.6 per 100,000).

                  resize iconView Larger
                  Within the 18-49 years and ≥ 65 years age groups, the hospitalization rates increased with increasing age.
                  Overall 60.5
                  0-4 years 3.0
                  5-17 years 1.4
                  18-49 years 32.6
                  18-29 years 15.4
                  30-39 years 32.0
                  40-49 years 55.6
                  50-64 years 94.4
                  65+ years 192.4
                  65-74 years 141.2
                  75-84 years 232.0
                  85+ years 352.0
                  Among 13,441 cases with information on race/ethnicity, 36.5% were non-Hispanic white, 40.0% were non-Hispanic black, 14.2% were Hispanic, and 9.3% were other race.
                  Overall 0-4 years 5-17 years 18-49 years 50-64 years 65+ years
                  Race N (%) N (%) N (%) N (%) N (%) N (%)
                  Cases with available race 1,3441 (68.4) 29 (50.0) 46 (62.2) 2,987 (63.6) 3,947 (67.5) 6,432 (71.8)
                  Non-Hispanic White 4,908 (36.5) 7 (24.1) 8 (17.4) 568 (19.0) 1,159 (29.4) 3,166 (49.2)
                  Non-Hispanic Black 5,372 (40.0) 9 (31.0) 16 (34.8) 1,165 (39.0) 1,780 (45.1) 2,402 (37.3)
                  Hispanic 1,906 (14.2) 7 (24.1) 19 (41.3) 898 (30.1) 616 (15.6) 366 (5.7)
                  Other1 1,255 (9.3) 6 (20.7) 3 (6.5) 356 (11.9) 392 (9.9) 498 (7.7)
                  Cases missing race2 6,196 (31.6) 29 (50.0) 28 (37.8) 1,708 (36.4) 1,904 (32.5) 2,527 (28.2)
                  1 Other includes data on persons who are Asian, American Indian/Alaskan Native, Multi-race, and persons for whom race/ethnicity data is unknown; 2 Cases with missing race include those for whom chart reviews have not yet been conducted to ascertain race; these data will be updated as additional race data become available

                  Among 3,734 hospitalized adults with information on underlying medical conditions, 91.7% had at least one reported underlying medical condition, the most commonly reported were hypertension, obesity, chronic metabolic disease, and cardiovascular disease.

                  resize iconView Larger


                  Additional hospitalization surveillance information: Surveillance Methods | Additional rate data | Additional demographic and clinical data


                  Mortality Surveillance


                  The National Center for Health Statistics (NCHS) collects death certificate data from vital statistics offices for all deaths occurring in the United States. Based on death certificate data available on May 14, 2020, 12.8% of all deaths occurring during the week ending May 9, 2020 (week 19) were due to pneumonia, influenza or COVID-19 (PIC). This is the third week of a declining percentage of deaths due to PIC; however, the percentage remains above the epidemic threshold of 6.6% for week 19. Data for recent weeks are incomplete, and the PIC percentage may increase as more death certificates representing deaths during these weeks are filed.

                  Weekly mortality surveillance data include a combination of machine coded and manually coded causes of death collected from death certificates. Percentages of deaths due to PIC are higher among manually coded records than more rapidly available machine coded records. Due to the additional time needed for manual coding, the initially reported PIC percentages may be lower than percentages calculated from final data. Given the amount of manually coded data available for deaths occurring during week 19, it is possible that when additional death certificates are processed, the week 19 PIC percentage may be greater than what was reported for week 18.

                  resize iconView Larger


                  *Data during recent weeks are incomplete because of the lag in time between when the death occurred and when the death certificate is completed, submitted to NCHS and processed for reporting purposes.
                  View Data Table


                  Additional NCHS mortality surveillance information: Surveillance Methods | Provisional Death Counts for COVID-19

                  View Page In:pdf icon 46 Pages, 2 MB
                  Page last reviewed: May 15, 2020
                  Content source: National Center for Immunization and Respiratory Diseases (NCIRD), Division of Viral DiseaseshomeCoronavirus Disease 2019 (COVID-19)email_03Get Email Updates

                  To receive email updates about COVID-19, enter your email address:
                  Email Address
                  What's this?
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                  Spanish Resourceshttps://www.cdc.gov/coronavirus/2019...iew/index.html
                  Twitter: @RonanKelly13
                  The views expressed are mine alone and do not represent the views of my employer or any other person or organization.

                  Comment


                  • #10
                    Updated May 22, 2020

                    Download Weekly Summary pdf icon[49 Pages, 3 MB]
                    Key Updates for Week 20, ending May 16, 2020


                    Nationally, levels of influenza-like illness (ILI) and COVID-19-like illness (CLI) and the percentage of specimens testing positive for SARS-CoV-2, the virus that causes COVID-19, continue to decline. Mortality attributed to COVID-19 also decreased compared to last week but remains elevated above baseline and may increase as additional death certificates are processed.
                    Virus

                    Public Health, Commercial and Clinical Laboratories


                    The national percentage of respiratory specimens testing positive for SARS-CoV-2 at public health, clinical and commercial laboratories decreased from week 19 to week 20. Percentages by type of laboratory:
                    • Public health laboratories – decreased from 10.7% during week 19 to 8.5% during week 20;
                    • Clinical laboratories – decreased from 6.4% during week 19 to 5.8% during week 20;
                    • Commercial laboratories – decreased from 9.9 % during week 19 to 7.9% during week 20.
                    Outpatient and Emergency Department Visits

                    Outpatient Influenza-Like Illness Network (ILINet) and National Syndromic Surveillance Program (NSSP)


                    Two indicators from existing surveillance systems are being used to track outpatient or emergency department (ED) visits for illness with symptoms compatible with COVID-19.
                    • Nationally, the percentages of visits for ILI and CLI decreased, compared to last week. Levels of ILI are below baseline nationally for the fifth week and in all 10 surveillance regions.

                    Recent changes in health care seeking behavior, including increasing use of telemedicine, recommendations to limit emergency department (ED) visits to severe illnesses, and increased practice of social distancing, are likely affecting data reported from both networks, making it difficult to draw further conclusions at this time. Tracking these systems moving forward will give additional insight into illness related to COVID-19.
                    Severe Disease

                    Hospitalizations


                    Cumulative COVID-19-associated hospitalization rates since March 1, 2020, are updated weekly. The overall cumulative hospitalization rate is 67.9 per 100,000, with the highest rates in people aged 65 years and older (214.4 per 100,000) and 50-64 years (105.9 per 100,000).
                    Mortality


                    Based on death certificate data, the percentage of deaths attributed to pneumonia, influenza or COVID-19 (PIC) decreased from 18.5% during week 19 to 12.0% during week 20 but remained above baseline. This is the fourth week of a declining percentage of deaths due to PIC, but this percentage may change as more death certificates are processed, particularly for recent weeks.

                    All data are preliminary and may change as more reports are received.

                    A description of the surveillance systems summarized in COVIDView, including methodology and detailed descriptions of each data component, is available on the surveillance methods page.
                    Key Points
                    • Nationally, the percentages of laboratory specimens testing positive for SARS-CoV-2 decreased compared to last week.
                      • While the number of specimens from children <18 years of age tested is low (<5% of all specimens tested in public health and commercial laboratories), the percentage of these testing positive for SARS-CoV-2 in this age group has either trended upward or remained relatively stable in recent weeks. Other age groups have seen declines in percent positivity during the same time period.
                    • Nationally, visits to outpatient providers and emergency departments (EDs) for illnesses with symptoms consistent with COVID-19 continued to decline. Outpatient ILI visits are below baseline nationally and in all regions of the country.
                      • The decrease in the percentage of people presenting for care with ILI and CLI may be due to a decline in COVID-19 illness, which could be in part a result of widespread adoption of social distancing in addition to changes in healthcare seeking behavior.
                      • There has been very little influenza virus activity in recent weeks.
                    • The overall cumulative COVID-19 associated hospitalization rate is 67.9 per 100,000, with the highest rates in people 65 years of age and older (214.4 per 100,000) followed by people 50-64 years (105.9 per 100,000). Hospitalization rates are cumulative and will increase as the COVID-19 pandemic continues.
                      • Hospitalization rates for COVID-19 in adults (18-64 years) are higher than hospitalization rates for influenza at comparable time points* during the past 5 influenza seasons.
                      • For people 65 years and older, current COVID-19 hospitalization rates are within ranges of influenza hospitalization rates observed at comparable time points* during recent influenza seasons.
                      • For children (0-17 years), COVID-19 hospitalization rates are much lower than influenza hospitalization rates at comparable time points* during recent influenza seasons.
                    • Based on death certificate data, the percentage of deaths attributed to pneumonia, influenza or COVID-19 (PIC) decreased from 18.5% during week 19 to 12.0% during week 20 but remained above baseline. This is the fourth week during which a declining percentage of deaths due to PIC has been recorded, but the percentage remains high compared with any influenza season. The percentage may change as additional death certificates for deaths during recent weeks are processed.

                    *Number of weeks since 10% of specimens tested positive for SARS-CoV-2 and influenza, respectively.
                    National 7.9 Declining (6 weeks) 1.1 Below Declining (8 weeks) 2.5 Declining (6 weeks) 12.0 Above Declining (4 weeks)
                    Region 1 9.4 Declining (5 weeks) 1.2 Below Declining (8 weeks) 4.0 Declining (5 weeks) 25.5 Above Declining (4 weeks)
                    Region 2 9.4 Declining (6 weeks) 1.8 Below Declining (7 weeks) 2.9 Declining (6 weeks) 25.1 Above Declining (4 weeks)
                    Region 3 12.0 Declining (4 weeks) 1.2 Below Declining (8 weeks) 3.4 Declining (5 weeks) 13.8 Above Declining (2 weeks)
                    Region 4 5.8 Declining (7 weeks) 0.8 Below No change 1.8 Declining (7 weeks) 6.2 Above Declining (4 weeks)
                    Region 5 7.8 Declining (3 weeks) 1.3 Below Increasing (1 week) 3.3 Declining (6 weeks) 8.8 Above Declining (4 weeks)
                    Region 6 7.0 Declining (6 weeks) 1.2 Below Declining (8 weeks) 2.0 Declining (7 weeks) 6.0 Below Declining (5 weeks)
                    Region 7 9.5 Declining (3 weeks) 0.6 Below No change 1.5 Declining (7 weeks) 7.2 Above Declining (1 week)
                    Region 8 5.4 Declining (3 weeks) 0.7 Below Declining (9 weeks) 2.8 Declining (7 weeks) 6.2 Below Declining (3 weeks)
                    Region 9 6.0 Declining (4 weeks) 0.8 Below Declining (8 weeks) 2.4 Declining (8 weeks) 7.2 Above Declining (4 weeks)
                    Region 10 4.4 Declining (4 weeks) 1.1 Below No change 1.5 Declining (8 weeks) Insufficient Data for Week 20
                    * Public health, clinical and commercial laboratory data combined.
                    U.S. Virologic Surveillance


                    The number of specimens tested for SARS-CoV-2 using a molecular assay and reported to CDC by public health laboratories and a subset of clinical and commercial laboratories in the United States are summarized below. All laboratories are performing primary diagnostic functions; therefore, the percentage of specimens testing positive across laboratory types can be used to monitor overall trends in COVID-19 activity. As the outbreak progresses, it is possible that different types of laboratories will take on different roles, and the data interpretation may need to change. The lower percentage of specimens testing positive in clinical laboratories compared to public health and commercial laboratories may be influenced by COVID-19 activity in areas with reporting laboratories and by larger proportions of specimens obtained from children tested in these laboratories
                    1,133,420 7,362,526
                    163,905 1,031,408
                    85,445 626,747
                    884,070 5,704,371
                    88,975 (7.9%) 1,049,239 (14.3%)
                    13,912 (8.5%) 139,682 (13.5%)
                    4,983 (5.8%) 53,424 (8.5%)
                    70,080 (7.9%) 856,133 (15.0%)
                    * Commercial and clinical laboratory data represents select laboratories and does not capture all tests performed in the United States.
                    Public Health Laboratories


                    resize iconView LargerView Data Table

                    Clinical Laboratories


                    resize iconView LargerView Data Table

                    Commercial Laboratories


                    resize iconView Larger


                    * Commercial laboratories began testing for SARS-CoV-2 in early March, but the number and geographic distribution of reporting commercial laboratories became stable enough to calculate a weekly percentage of specimens testing positive as of March 29, 2020.
                    View Data Table


                    Additional virologic surveillance information: Surveillance Methods


                    Outpatient/Emergency Department Illness


                    Two syndromic surveillance systems are being used to monitor trends in outpatient and emergency department visits that may be associated with COVID-19 illness. Each system monitors a slightly different syndrome, and together these systems provide a more comprehensive picture of mild to moderate COVID-19 illness than either would individually. Both systems are currently being affected by recent changes in healthcare seeking behavior, including increased use of telemedicine, compliance with recommendations to limit emergency department (ED) visits to severe illnesses, and increased practice of social distancing. These changes affect the numbers of people seeking care in the outpatient and ED settings and their reasons for doing so.
                    ILINet


                    The U.S. Outpatient Influenza-like Illness Surveillance Network (ILINet) provides data on visits for influenza-like illness (ILI) (fever [≥100F] and cough and/or sore throat) to approximately 2,600 primary care providers, emergency departments and urgent care centers in all 50 states, Puerto Rico, the District of Columbia and the U.S. Virgin Islands. Mild COVID-19 illness presents with symptoms similar to ILI, so ILINet is being used to track trends of mild to moderate COVID-19 illness and allows for comparison with prior influenza seasons.

                    Nationwide during week 20, 1.1% of patient visits reported through ILINet were due to ILI. This percentage is low and below the national baseline of 2.4% and represents the eighth week of decline after three weeks of increase beginning in early March. Compared to week 19, the percentage of visits for ILI in week 20 decreased among adults 25 years of age and older, stayed the same in children and adults aged 5-24 years, and increased slightly in children 0-4 years of age. Nationally, laboratory-confirmed influenza activity as reported by clinical laboratories has decreased to levels usually seen during summer months which, along with changes in healthcare seeking behavior and the impact of social distancing, is likely contributing to the decrease in ILI activity.

                    resize iconView Larger


                    * Age-group specific percentages should not be compared to the national baseline.

                    On a regional levelexternal icon, the percentage of outpatient visits for ILI ranged from 0.6% to 1.8% during week 20. Compared to week 19, the percent of outpatient visits for ILI increased slightly in region 5, remained unchanged in regions 4, 7, and 10, and decreased in the remaining 6 regions. All ten regions are below their region-specific baselines.
                    Overall Percentage of Visits for ILI | Age Group ILI Data

                    ILI Activity Levels


                    Data collected in ILINet are used to produce a measure of ILI activity for all 50 states, Puerto Rico, the District of Columbia and New York City. The mean reported percentage of visits due to ILI for the current week is compared to the mean reported during non-influenza weeks, and the activity levels correspond to the number of standard deviations below, at or above the mean.

                    The number of jurisdictions at each activity level during week 20 and the change compared to the previous week are summarized in the table below and shown in the following maps. The decreasing percentage of visits for ILI described above are reflected in this week’s ILI activity levels.
                    Activity Level Number of Jurisdictions
                    Week 20
                    (Week ending May 16, 2020)
                    Compared to Previous Week
                    Very High 0 No change
                    High 1 No change
                    Moderate 2 No change
                    Low 2 -1
                    Minimal 48 +1
                    Insufficient Data* 1 No change
                    *Data collected in ILINet may disproportionally represent certain populations within a state and may not accurately depict the full picture of influenza activity for the whole state. Differences in the data presented here by CDC and independently by some state health departments likely represent differing levels of data completeness with data presented by the state likely being the more complete.
                    National Syndromic Surveillance Program (NSSP): Emergency Department (ED) Visits


                    NSSP is a collaboration among CDC, federal partners, local and state health departments and academic and private sector partners to collect, analyze and share electronic patient encounter data received from multiple healthcare settings. To track trends of potential COVID-19 visits, visits for COVID-19-like illness (CLI) (fever and cough or shortness of breath or difficulty breathing or presence of a coronavirus diagnosis code) and ILI to a subset of emergency departments in 47 states are being monitored.

                    Nationwide during week 20, 2.5% of emergency department visits captured in NSSP were due to CLI and 0.8% were due to ILI. This is the eighth week of decline in percentage of visits for ILI and the sixth week of declining percentage of visits for CLI. Compared to week 19, all 10 HHS regionsexternal icon had declining percentages of visits for CLI during week 20; 7 regions also had declining percentages of visits for ILI while regions 4, 6 and 7 had no change in percent of visits for ILI from week 19 to week 20.

                    resize iconView LargerView Data Table


                    Additional information about medically attended outpatient and emergency department visits for ILI and CLI: Surveillance Methods


                    Hospitalizations


                    The COVID-19-Associated Hospitalization Surveillance Network (COVID-NET) conducts population-based surveillance for laboratory-confirmed COVID-19-associated hospitalizations in select counties participating in the Emerging Infections Program (EIP) and states participating in the Influenza Hospitalization Surveillance Project (IHSP). COVID-NET-estimated hospitalization rates are updated weekly.

                    A total of 22,060 laboratory-confirmed COVID-19-associated hospitalizations were reported by sites between March 1, 2020, and May 16, 2020. The overall cumulative hospitalization rate was 67.9 per 100,000 population. Among the 0-4 years, 5-17 years, 18-49 years, 50-64 years, and ≥ 65 years age groups, the highest rate of hospitalization is among adults aged 65 years (214.4 per 100,000), followed by adults aged 50-64 years (105.9 per 100,000) and adults aged 18-49 years (37.2 per 100,000).

                    resize iconView Larger
                    Within the 18-49 years and ≥ 65 years age groups, the hospitalization rates increased with increasing age.
                    Overall 67.9
                    0-4 years 3.5
                    5-17 years 1.7
                    18-49 years 37.2
                    18-29 years 17.8
                    30-39 years 36.8
                    40-49 years 62.8
                    50-64 years 105.9
                    65+ years 214.4
                    65-74 years 156.6
                    75-84 years 258.3
                    85+ years 396.4
                    Among 18,136 cases with information on race/ethnicity, 35.8% were non-Hispanic white, 34.9% were non-Hispanic black, 17.4% were Hispanic, and 11.8% were other race.
                    Overall 0-4 years 5-17 years 18-49 years 50-64 years 65+ years
                    Race N (%) N (%) N (%) N (%) N (%) N (%)
                    Cases with available race 18,136 (82.2) 52 (76.5) 72 (79.1) 4,170 (77.9) 5,304 (80.8) 8,538 (85.5)
                    Non-Hispanic White 6,495 (35.8) 11 (21.2) 10 (13.9) 760 (18.2) 1,533 (28.9) 4,181 (49.0)
                    Non-Hispanic Black 6,331 (34.9) 10 (19.2) 24 (33.3) 1,362 (32.7) 2,108 (39.7) 2,827 (33.1)
                    Hispanic 3,162 (17.4) 22 (42.3) 32 (44.4) 1,451 (34.8) 981 (18.5) 676 (7.9)
                    Other1 2,148 (11.8) 9 (17.3) 6 (8.3) 597 (14.3) 682 (12.9) 854 (10.0)
                    Cases missing race2 3,924 (17.8) 16 (23.5) 19 (20.9) 1,186 (22.1) 1,257 (19.2) 1,446 (14.5)
                    1 Other includes data on persons who are Asian, American Indian/Alaskan Native, Multi-race, and persons for whom race/ethnicity data is unknown; 2 Cases with missing race include those for whom chart reviews have not yet been conducted to ascertain race; these data will be updated as additional race data become available; NH=non-Hispanic

                    Among 4,247 hospitalized adults with information on underlying medical conditions, 92.1% had at least one reported underlying medical condition, the most commonly reported were hypertension, obesity, chronic metabolic disease, and cardiovascular disease.

                    resize iconView Larger


                    Additional hospitalization surveillance information: Surveillance Methods | Additional rate data | Additional demographic and clinical data


                    Mortality Surveillance


                    The National Center for Health Statistics (NCHS) collects death certificate data from vital statistics offices for all deaths occurring in the United States. Based on death certificate data available on May 21, 2020, 12.0% of all deaths occurring during the week ending May 16, 2020 (week 20) were due to pneumonia, influenza or COVID-19 (PIC). This is the fourth week of a declining percentage of deaths due to PIC; however, the percentage remains above the epidemic threshold of 6.5% for week 20 and is high compared to any influenza season. Data for recent weeks are incomplete, and the PIC percentage may increase as more death certificates representing deaths during these weeks are processed.

                    Weekly mortality surveillance data include a combination of machine coded and manually coded causes of death collected from death certificates. Percentages of deaths due to PIC are higher among manually coded records than more rapidly available machine coded records. Due to the additional time needed for manual coding, the initially reported PIC percentages may be lower than percentages calculated from final data. Given the amount of manually coded data available for deaths occurring during week 20, it is possible that when additional death certificates are processed, the week 20 PIC percentage may be greater than what was reported for week 19.

                    resize iconView Larger


                    *Data during recent weeks are incomplete because of the lag in time between when the death occurred and when the death certificate is completed, submitted to NCHS and processed for reporting purposes.
                    View Data Table


                    Additional NCHS mortality surveillance information: Surveillance Methods | Provisional Death Counts for COVID-19

                    View Page In:pdf icon 49 Pages, 3 MB
                    Page last reviewed: May 22, 2020
                    Content source: National Center for Immunization and Respiratory Diseases (NCIRD), Division of Viral DiseaseshomeCoronavirus Disease 2019 (COVID-19)email_03Get Email Updates

                    To receive email updates about COVID-19, enter your email address:
                    Email Address
                    What's this?
                    Submit
                    Spanish Resourceshttps://www.cdc.gov/coronavirus/2019...iew/index.html
                    Twitter: @RonanKelly13
                    The views expressed are mine alone and do not represent the views of my employer or any other person or organization.

                    Comment


                    • #11
                      COVIDView: A Weekly Surveillance Summary of U.S. COVID-19 Activity


                      Print Page
                      Updated May 29, 2020

                      Download Weekly Summary pdf icon[47 Pages, 2 MB]
                      Key Updates for Week 21, ending May 23, 2020


                      Nationally, levels of influenza-like illness (ILI) and COVID-19-like illness (CLI) and the percentage of specimens testing positive for SARS-CoV-2, the virus that causes COVID-19, continue to decline or remain stable. Mortality attributed to COVID-19 also decreased compared to last week but remains elevated above baseline and may increase as additional death certificates are processed.
                      Virus

                      Public Health, Commercial and Clinical Laboratories


                      The national percentage of respiratory specimens testing positive for SARS-CoV-2 at public health, clinical and commercial laboratories decreased from week 20 to week 21; however, percent positivity increased slightly in two regions. National percentages by type of laboratory:
                      • Public health laboratories – decreased from 8.4% during week 20 to 7.0% during week 21;
                      • Clinical laboratories – decreased from 6.3% during week 20 to 5.6% during week 21;
                      • Commercial laboratories – decreased from 7.8 % during week 20 to 6.9% during week 21.
                      Outpatient and Emergency Department Visits

                      Outpatient Influenza-Like Illness Network (ILINet) and National Syndromic Surveillance Program (NSSP)


                      Two surveillance indicators are being used to track outpatient or emergency department (ED) visits for illness with symptoms compatible with COVID-19.
                      • Nationally, the percentages of visits for ILI and CLI decreased or remained stable at low levels, compared to last week. Levels of ILI are below baseline nationally for the sixth week and in all 10 surveillance regions for the past four to seven weeks.

                      Recent changes in health care seeking behavior, including increasing use of telemedicine, recommendations to limit emergency department (ED) visits to severe illnesses, and increased practice of social distancing, are likely affecting data reported from both networks, making it difficult to draw conclusions at this time. Tracking these systems moving forward will give additional insight into illness related to COVID-19.
                      Severe Disease

                      Hospitalizations


                      Cumulative COVID-19-associated hospitalization rates since March 1, 2020, are updated weekly. The overall cumulative COVID-19 hospitalization rate is 73.3 per 100,000, with the highest rates in people aged 65 years and older (229.7 per 100,000) and 50-64 years (113.4 per 100,000).
                      Mortality


                      Based on death certificate data, the percentage of deaths attributed to pneumonia, influenza or COVID-19 (PIC) decreased from 15.9% during week 20 to 9.8% during week 21 but remained above baseline. This is the fifth week of a declining percentage of deaths due to PIC, but this percentage may change as more death certificates are processed, particularly for recent weeks.

                      All data are preliminary and may change as more reports are received.

                      A description of the surveillance systems summarized in COVIDView, including methodology and detailed descriptions of each data component, is available on the surveillance methods page.
                      Key Points
                      • Nationally, the percentages of laboratory specimens testing positive for SARS-CoV-2 with a molecular assay decreased compared to last week; however, there are two developments in particular worth noting:
                        • The percent positivity increased slightly in two HHS surveillance regions (Regions 4 [the southeast] and 10 [the Pacific northwest]).
                        • While the number of specimens from children <18 years of age tested is low (<5% of all specimens tested in public health and commercial laboratories), the percentage testing positive for SARS-CoV-2 in this age group has either trended upward or remained relatively stable in recent weeks. Other age groups have seen declines in percent positivity during the same time period.
                      • Nationally, visits to outpatient providers and emergency departments (EDs) for illnesses with symptoms consistent with COVID-19 continued to decline or remain stable at low levels. Outpatient ILI visits are below baseline nationally and in all regions of the country.
                        • The decrease in the percentage of people presenting for care with ILI and CLI may be due to a decline in COVID-19 illness, which could be in part a result of widespread adoption of social distancing, in addition to decreases in healthcare seeking behavior.
                        • There has been very little influenza virus activity in recent weeks.
                      • The overall cumulative COVID-19 associated hospitalization rate is 73.3 per 100,000, with the highest rates in people 65 years of age and older (229.7 per 100,000) followed by people 50-64 years (113.4 per 100,000). Hospitalization rates are cumulative and will increase as the COVID-19 pandemic continues.
                        • This week’s report presents additional information on racial and ethnic disparities among reported COVID-19 hospitalizations. Non-Hispanic Black and non-Hispanic American Indian/Alaska Native populations have rates approximately 4.5 times that of non-Hispanic Whites, while Hispanic/Latinos have a rate approximately 3.5 times that of non-Hispanic Whites.
                        • Cumulative hospitalization rates for COVID-19 in adults (18-64 years) at this time are higher than cumulative end-of-season hospitalization rates for influenza over each of the past 5 influenza seasons.
                        • For people 65 years and older, current cumulative COVID-19 hospitalization rates are within ranges of cumulative influenza hospitalization rates observed at comparable time points* during recent influenza seasons.
                        • For children (0-17 years), cumulative COVID-19 hospitalization rates are much lower than cumulative influenza hospitalization rates at comparable time points* during recent influenza seasons.
                      • Based on death certificate data, the percentage of deaths attributed to pneumonia, influenza or COVID-19 (PIC) decreased from 15.9% during week 20 to 9.8% during week 21 but remained above baseline. This is the fifth week during which a declining percentage of deaths due to PIC has been recorded. The percentage remains above the epidemic threshold, and is now similar to what has been observed at the peak of some influenza seasons. The percentage may change as additional death certificates for deaths during recent weeks are processed.

                      *Number of weeks since 10% of specimens tested positive for SARS-CoV-2 and influenza, respectively.

                      U.S. Virologic Surveillance


                      The number of specimens tested for SARS-CoV-2 using a molecular assay and reported to CDC by public health laboratories and a subset of clinical and commercial laboratories in the United States are summarized below. All laboratories are performing primary diagnostic functions; therefore, the percentage of specimens testing positive across laboratory types can be used to monitor overall trends in COVID-19 activity. As the outbreak progresses, it is possible that different types of laboratories will take on different roles, and the data interpretation may need to change. The lower percentage of specimens testing positive in clinical laboratories compared to public health and commercial laboratories may be influenced by COVID-19 activity in areas with reporting laboratories and by larger proportions of specimens obtained from children tested in these laboratories.
                      1,171,546 8,762,465
                      182,009 1,227,717
                      72,256 740,691
                      917,281 6,794,057
                      79,898 (6.8%) 1,145,733 (13.1%)
                      12,702 (7.0%) 153,579 (12.5%)
                      4,041 (5.6%) 60,520 (8.2%)
                      63,155 (6.9%) 931,634 (13.7%)
                      * Commercial and clinical laboratory data represents select laboratories and does not capture all tests performed in the United States.
                      Public Health Laboratories


                      resize iconView LargerView Data Table

                      Clinical Laboratories


                      resize iconView LargerView Data Table

                      Commercial Laboratories


                      resize iconView Larger


                      * Commercial laboratories began testing for SARS-CoV-2 in early March, but the number and geographic distribution of reporting commercial laboratories became stable enough to calculate a weekly percentage of specimens testing positive as of March 29, 2020.
                      View Data Table


                      Additional virologic surveillance information: Surveillance Methods


                      Outpatient/Emergency Department Illness


                      Two syndromic surveillance systems are being used to monitor trends in outpatient and emergency department visits that may be associated with COVID-19 illness. Each system monitors a slightly different syndrome, and together these systems provide a more comprehensive picture of mild to moderate COVID-19 illness than either would individually. Both systems are currently being affected by recent changes in healthcare seeking behavior, including increased use of telemedicine, compliance with recommendations to limit emergency department (ED) visits to severe illnesses, and increased practice of social distancing. These changes affect the numbers of people seeking care in the outpatient and ED settings and their reasons for doing so.
                      ILINet


                      The U.S. Outpatient Influenza-like Illness Surveillance Network (ILINet) provides data on visits for influenza-like illness (ILI) (fever [≥100F] and cough and/or sore throat) to approximately 2,600 primary care providers, emergency departments and urgent care centers in all 50 states, Puerto Rico, the District of Columbia and the U.S. Virgin Islands. Mild COVID-19 illness presents with symptoms similar to ILI, so ILINet is being used to track trends of mild to moderate COVID-19 illness and allows for comparison with prior influenza seasons.

                      Nationwide during week 21, 1.0% of patient visits reported through ILINet were due to ILI. This percentage is low and below the national baseline of 2.4% and represents the ninth week of decline after three weeks of increase beginning in early March. Compared to week 20, the percentage of visits for ILI in week 21 decreased slightly among all age groups. Nationally, laboratory-confirmed influenza activity as reported by clinical laboratories is at levels usually seen during summer months which, along with changes in healthcare seeking behavior and the impact of social distancing, is likely contributing to the low level of ILI activity.

                      resize iconView Larger


                      * Age-group specific percentages should not be compared to the national baseline.

                      On a regional levelexternal icon, the percentage of outpatient visits for ILI ranged from 0.4% to 1.5% during week 21. Compared to week 20, the percent of outpatient visits for ILI decreased or remained stable at low levels in all ten regions and all regions are below their region-specific baselines.

                      Note: In response to the COVID-19 pandemic, new sites will be enrolled in ILINet throughout the summer. This will result in an increase in patient visits and the percentage of visits for ILI may change in comparison to previous weeks. During week 21, new sites were added in Regions 1, 4, and 6. While these regions remain below baseline levels for ILI, these system changes should be kept in mind when drawing conclusions from these data. Any changes in ILI due to changes in respiratory virus circulation will be highlighted here.
                      Overall Percentage of Visits for ILI | Age Group ILI Data

                      ILI Activity Levels


                      Data collected in ILINet are used to produce a measure of ILI activity for all 50 states, Puerto Rico, the District of Columbia and New York City. The mean reported percentage of visits due to ILI for the current week is compared to the mean reported during non-influenza weeks, and the activity levels correspond to the number of standard deviations below, at or above the mean.

                      The number of jurisdictions at each activity level during week 21 and the change compared to the previous week are summarized in the table below and shown in the following maps. The decreasing percentage of visits for ILI described above are reflected in this week’s ILI activity levels.
                      Activity Level Number of Jurisdictions
                      Week 21
                      (Week ending May 23, 2020)
                      Compared to Previous Week
                      Very High 0 No change
                      High 1 No change
                      Moderate 0 -2
                      Low 2 No change
                      Minimal 49 +1
                      Insufficient Data 2 +1
                      *Data collected in ILINet may disproportionally represent certain populations within a state and may not accurately depict the full picture of influenza activity for the whole state. Differences in the data presented here by CDC and independently by some state health departments likely represent differing levels of data completeness with data presented by the state likely being the more complete.
                      National Syndromic Surveillance Program (NSSP): Emergency Department (ED) Visits


                      NSSP is a collaboration among CDC, federal partners, local and state health departments and academic and private sector partners to collect, analyze and share electronic patient encounter data received from multiple healthcare settings. To track trends of potential COVID-19 visits, visits for COVID-19-like illness (CLI) (fever and cough or shortness of breath or difficulty breathing or presence of a coronavirus diagnosis code) and ILI to a subset of emergency departments in 47 states are being monitored.

                      Nationwide during week 21, 2.2% of emergency department visits captured in NSSP were due to CLI and 0.7% were due to ILI. This is the ninth week of decline in the percentage of visits for ILI and the seventh week of declining percentage of visits for CLI. Compared to week 20, all 10 HHS regionsexternal icon had declining percentages of visits for CLI during week 21; all 10 regions also had declining or stable percentages of visits for ILI.



                      Additional information about medically attended outpatient and emergency department visits for ILI and CLI: Surveillance Methods


                      Hospitalizations


                      The COVID-19-Associated Hospitalization Surveillance Network (COVID-NET) conducts population-based surveillance for laboratory-confirmed COVID-19-associated hospitalizations in select counties participating in the Emerging Infections Program (EIP) and the Influenza Hospitalization Surveillance Project (IHSP).

                      A total of 23,811 laboratory-confirmed COVID-19-associated hospitalizations were reported by sites between March 1, 2020, and May 23, 2020. The overall cumulative hospitalization rate was 73.3 per 100,000 population. Among the 0-4 years, 5-17 years, 18-49 years, 50-64 years, and ≥ 65 years age groups, the highest rate of hospitalization is among adults aged 65 years (229.7 per 100,000), followed by adults aged 50-64 years (113.4 per 100,000) and adults aged 18-49 years (41.0 per 100,000).

                      resize iconView Larger
                      Within the 18-49 years and ≥ 65 years age groups, the hospitalization rates increased with increasing age.
                      Overall 73.3
                      0-4 years 4.1
                      5-17 years 1.9
                      18-49 years 41.0
                      18-29 years 20.1
                      30-39 years 40.7
                      40-49 years 68.5
                      50-64 years 113.4
                      65+ years 229.7
                      65-74 years 167.6
                      75-84 years 276.2
                      85+ years 426.7
                      Among the 23,811 laboratory-confirmed COVID-19-associated hospitalized cases, 19,775 (83%) had information available on race and ethnicity while collection of race and ethnicity data was still pending for 4,036 (17%) cases. Of the 19,775 cases with race and ethnicity data, 35.6% were non-Hispanic White, 34.1% were non-Hispanic Black, 17.9% were Hispanic/Latino, 4.5% were non-Hispanic Asian/Pacific Islander, 1.4% were non-Hispanic American Indian/Alaska Native, 0.2% were multiple race, and 6.3% had unknown race. In comparison, the COVID-NET catchment area population includes 58.8% non-Hispanic White, 17.7% non-Hispanic Black, 14.0% Hispanic/Latino, 8.8% non-Hispanic Asian/Pacific Islander, and 0.7% non-Hispanic American Indian/Alaska Native residents. Additional data on race and ethnicity by age are available.

                      COVID-19-associated hospitalization rates by race and ethnicity are calculated using hospitalized COVID-NET cases with known race and ethnicity for the numerator and NCHS bridged-race population estimates for the denominator. Rates are adjusted to account for differences in age distributions within race and ethnicity strata in the COVID-NET catchment area; the age strata used for the adjustment include 0-17, 18-49, 50-64, 75-84, and ≥85 years. Age-adjusted hospitalization rates are highest in non-Hispanic American Indian/Alaska Native and non-Hispanic Black populations, followed by Hispanic/Latino. Non-Hispanic Black and non-Hispanic American Indian/Alaska Native populations have a rate approximately 4.5 times that of non-Hispanic Whites, while Hispanic/Latinos have a rate approximately 3.5 times that of non-Hispanic Whites.

                      Among 5,187 hospitalized adults with information on underlying medical conditions, 91.7% had at least one reported underlying medical condition, the most commonly reported were hypertension, obesity, chronic metabolic disease, and cardiovascular disease.

                      resize iconView Larger


                      Additional hospitalization surveillance information: Surveillance Methods | Additional rate data | Additional demographic and clinical data


                      Mortality Surveillance


                      The National Center for Health Statistics (NCHS) collects death certificate data from vital statistics offices for all deaths occurring in the United States. Based on death certificate data available on May 28, 2020, 9.8% of all deaths occurring during the week ending May 23, 2020 (week 21) were due to pneumonia, influenza or COVID-19 (PIC). This is the fifth week of a declining percentage of deaths due to PIC; however, the percentage remains above the epidemic threshold of 6.4% for week 21. Data for recent weeks are incomplete, and the PIC percentage may increase as more death certificates representing deaths during these weeks are processed.

                      Weekly mortality surveillance data include a combination of machine coded and manually coded causes of death collected from death certificates. Percentages of deaths due to PIC are higher among manually coded records than more rapidly available machine coded records. Due to the additional time needed for manual coding, the initially reported PIC percentages may be lower than percentages calculated from final data.

                      resize iconView Larger


                      *Data during recent weeks are incomplete because of the lag in time between when the death occurred and when the death certificate is completed, submitted to NCHS and processed for reporting purposes.
                      View Data Table


                      Additional NCHS mortality surveillance information: Surveillance Methods | Provisional Death Counts for COVID-19

                      More Information
                      View Page In:pdf icon 49 Pages, 3 MB
                      Page last reviewed: May 29, 2020
                      Content source: National Center for Immunization and Respiratory Diseases (NCIRD), Division of Viral Diseases

                      https://www.cdc.gov/coronavirus/2019...iew/index.html
                      Twitter: @RonanKelly13
                      The views expressed are mine alone and do not represent the views of my employer or any other person or organization.

                      Comment


                      • #12
                        COVIDView: A Weekly Surveillance Summary of U.S. COVID-19 Activity


                        Print Page
                        Updated June 5, 2020

                        Download Weekly Summary pdf icon[47 Pages, 2 MB]
                        Key Updates for Week 22, ending May 30, 2020


                        Nationally, levels of influenza-like illness (ILI) and COVID-19-like illness (CLI) and the percentage of specimens testing positive for SARS-CoV-2, the virus that causes COVID-19, continue to decline or remain stable at low levels. Mortality attributed to COVID-19 also decreased compared to last week but remains elevated above baseline and may increase as additional death certificates are processed.
                        Virus

                        Public Health, Commercial and Clinical Laboratories


                        The national percentage of respiratory specimens testing positive for SARS-CoV-2 at public health, clinical and commercial laboratories decreased from week 21 to week 22; however, percent positivity increased slightly in four regions. National percentages by type of laboratory:
                        • Public health laboratories – decreased from 6.8% during week 21 to 6.0% during week 22;
                        • Clinical laboratories – decreased from 6.0% during week 21 to 5.9% during week 22;
                        • Commercial laboratories – decreased from 6.5% during week 21 to 5.9% during week 22.
                        Outpatient and Emergency Department Visits

                        Outpatient Influenza-Like Illness Network (ILINet) and National Syndromic Surveillance Program (NSSP)


                        Two surveillance indicators are being used to track outpatient or emergency department (ED) visits for illness with symptoms compatible with COVID-19.
                        • Nationally, the percentages of visits for ILI and CLI decreased or remained stable at low levels, compared to last week. Levels of ILI are below baseline nationally for the seventh week and in all 10 surveillance regions for the past five to eight weeks.

                        Recent changes in health care seeking behavior, including increasing use of telemedicine, recommendations to limit emergency department (ED) visits to severe illnesses, and increased practice of social distancing, are likely affecting data reported from both networks, making it difficult to draw conclusions at this time. Tracking these systems moving forward will give additional insight into illness related to COVID-19.
                        Severe Disease

                        Hospitalizations


                        Cumulative COVID-19-associated hospitalization rates since March 1, 2020, are updated weekly. The overall cumulative COVID-19 hospitalization rate is 82.0 per 100,000, with the highest rates in people aged 65 years and older (254.7 per 100,000) and 50-64 years (126.2 per 100,000).
                        Mortality


                        Based on death certificate data, the percentage of deaths attributed to pneumonia, influenza or COVID-19 (PIC) decreased from 13.7% during week 21 to 8.4% during week 22 but remained above baseline. This is the sixth week of a declining percentage of deaths due to PIC, but this percentage may change as more death certificates are processed, particularly for recent weeks.

                        All data are preliminary and may change as more reports are received.

                        A description of the surveillance systems summarized in COVIDView, including methodology and detailed descriptions of each data component, is available on the surveillance methods page.
                        Key Points
                        • Nationally, the percentages of laboratory specimens testing positive for SARS-CoV-2 with a molecular assay decreased compared to last week; however, there are two developments in particular worth noting:
                          • The percent positivity increased in four HHS surveillance regions: Region 4 (the southeast), Region 6 (the south central, Region 9 (the west coast) and Region 10 (the Pacific northwest).
                          • While the number of specimens from children <18 years of age tested is low (<5% of all specimens tested in public health and commercial laboratories), the percentage testing positive for SARS-CoV-2 in this age group continued to either trend upward or remain relatively stable while other age groups have seen consistent declines in percent positivity in recent weeks.
                        • Nationally, visits to outpatient providers and emergency departments (EDs) for illnesses with symptoms consistent with COVID-19 continued to decline or remain stable at low levels. Outpatient ILI visits are below baseline nationally and in all regions of the country.
                          • The decrease in the percentage of people presenting for care with ILI and CLI may be due to a decline in COVID-19 illness, which could be in part a result of widespread adoption of social distancing, in addition to decreases in healthcare seeking behavior.
                          • There has been very little influenza virus activity in recent weeks.
                        • The overall cumulative COVID-19 associated hospitalization rate is 82.0 per 100,000, with the highest rates in people 65 years of age and older (254.7 per 100,000) followed by people 50-64 years (126.2 per 100,000). Hospitalization rates are cumulative and will increase as the COVID-19 pandemic continues.
                          • Non-Hispanic American Indian or Alaska Native persons have a rate approximately 5 times that of non-Hispanic White persons, non-Hispanic Black persons have a rate approximately 4.5 times that of non-Hispanic White persons, while Hispanics or Latino persons have a rate approximately 3.5 times that of non-Hispanic White persons.
                          • Cumulative hospitalization rates for COVID-19 in adults (18-64 years) at this time are higher than cumulative end-of-season hospitalization rates for influenza over each of the past 5 influenza seasons.
                          • For people 65 years and older, current cumulative COVID-19 hospitalization rates are within ranges of cumulative influenza hospitalization rates observed at comparable time points* during recent influenza seasons.
                          • For children (0-17 years), cumulative COVID-19 hospitalization rates are much lower than cumulative influenza hospitalization rates at comparable time points* during recent influenza seasons.
                        • Based on death certificate data, the percentage of deaths attributed to pneumonia, influenza or COVID-19 (PIC) decreased from 13.7% during week 21 to 8.4% during week 22. This is the sixth week during which a declining percentage of deaths due to PIC has been recorded; however, the percentage remains above the epidemic threshold, and is now similar to what has been observed at the peak of some influenza seasons. The percentage may change as additional death certificates for deaths during recent weeks are processed.

                        *Number of weeks since 10% of specimens tested positive for SARS-CoV-2 and influenza, respectively.

                        U.S. Virologic Surveillance


                        The number of specimens tested for SARS-CoV-2 using a molecular assay and reported to CDC by public health laboratories and a subset of clinical and commercial laboratories in the United States are summarized below. All laboratories are performing primary diagnostic functions; therefore, the percentage of specimens testing positive across laboratory types can be used to monitor overall trends in COVID-19 activity. As the outbreak progresses, it is possible that different types of laboratories will take on different roles, and the data interpretation may need to change.
                        1,054,626 10,337,330
                        175,585 1,426,171
                        88,660 922,190
                        790,381 7,988,969
                        62,403 (5.9%) 1,239,169 (12.0%)
                        10,529 (6.0%) 163,645 (11.5%)
                        5,206 (5.9%) 75,477 (8.2%)
                        46,668 (5.9%) 1,000,047 (12.5%)
                        * Commercial and clinical laboratory data represents select laboratories and does not capture all tests performed in the United States.
                        Public Health Laboratories


                        resize iconView LargerView Data Table

                        Clinical Laboratories


                        resize iconView LargerView Data Table

                        Commercial Laboratories


                        resize iconView Larger


                        * Commercial laboratories began testing for SARS-CoV-2 in early March, but the number and geographic distribution of reporting commercial laboratories became stable enough to calculate a weekly percentage of specimens testing positive as of March 29, 2020.
                        View Data Table


                        Additional virologic surveillance information: Surveillance Methods


                        Outpatient/Emergency Department Illness


                        Two syndromic surveillance systems are being used to monitor trends in outpatient and emergency department visits that may be associated with COVID-19 illness. Each system monitors a slightly different syndrome, and together these systems provide a more comprehensive picture of mild to moderate COVID-19 illness than either would individually. Both systems are currently being affected by recent changes in healthcare seeking behavior, including increased use of telemedicine, compliance with recommendations to limit emergency department (ED) visits to severe illnesses, and increased practice of social distancing. These changes affect the numbers of people seeking care in the outpatient and ED settings and their reasons for doing so.
                        ILINet


                        The U.S. Outpatient Influenza-like Illness Surveillance Network (ILINet) provides data on visits for influenza-like illness (ILI) (fever [≥100F] and cough and/or sore throat) to approximately 2,600 primary care providers, emergency departments and urgent care centers in all 50 states, Puerto Rico, the District of Columbia and the U.S. Virgin Islands. Mild COVID-19 illness presents with symptoms similar to ILI, so ILINet is being used to track trends of mild to moderate COVID-19 illness and allows for comparison with prior influenza seasons.

                        Nationwide during week 22, 0.9% of patient visits reported through ILINet were due to ILI. This percentage is well below the national baseline of 2.4% and represents the tenth week of decline after three weeks of increase beginning in early March. The percentage of visits for ILI in week 22 remains low among all age groups. Nationally, laboratory-confirmed influenza activity as reported by clinical laboratories is at levels usually seen during summer months which, along with changes in healthcare seeking behavior and the impact of social distancing, is likely contributing to the low level of ILI activity.

                        resize iconView Larger


                        * Age-group specific percentages should not be compared to the national baseline.

                        On a regional levelexternal icon, the percentage of outpatient visits for ILI ranged from 0.5% to 1.3% during week 22. All ten regions are at low levels and below their region-specific baselines.

                        Note: In response to the COVID-19 pandemic, new sites will be enrolled in ILINet throughout the summer. This will result in an increase in patient visits and the percentage of visits for ILI may change in comparison to previous weeks. During week 21, new sites were added in Regions 1, 4, and 6. While these regions remain below baseline levels for ILI, these system changes should be kept in mind when drawing conclusions from these data. Any changes in ILI due to changes in respiratory virus circulation will be highlighted here.
                        Overall Percentage of Visits for ILI | Age Group ILI Data

                        ILI Activity Levels


                        Data collected in ILINet are used to produce a measure of ILI activity for all 50 states, Puerto Rico, the District of Columbia and New York City. The mean reported percentage of visits due to ILI for the current week is compared to the mean reported during non-influenza weeks, and the activity levels correspond to the number of standard deviations below, at or above the mean.

                        The number of jurisdictions at each activity level during week 22 and the change compared to the previous week are summarized in the table below and shown in the following maps. The decreasing percentage of visits for ILI described above are reflected in this week’s ILI activity levels.
                        Activity Level Number of Jurisdictions
                        Week 22
                        (Week ending May 30, 2020)
                        Compared to Previous Week
                        Very High 0 No change
                        High 0 -1
                        Moderate 1 +1
                        Low 1 -1
                        Minimal 51 +2
                        Insufficient Data 1 -1
                        *Data collected in ILINet may disproportionally represent certain populations within a state and may not accurately depict the full picture of influenza activity for the whole state. Differences in the data presented here by CDC and independently by some state health departments likely represent differing levels of data completeness with data presented by the state likely being the more complete.
                        National Syndromic Surveillance Program (NSSP): Emergency Department (ED) Visits


                        NSSP is a collaboration among CDC, federal partners, local and state health departments and academic and private sector partners to collect, analyze and share electronic patient encounter data received from multiple healthcare settings. To track trends of potential COVID-19 visits, visits for COVID-19-like illness (CLI) (fever and cough or shortness of breath or difficulty breathing or presence of a coronavirus diagnosis code) and ILI to a subset of emergency departments in 47 states are being monitored.

                        Nationwide during week 22, 1.8% of emergency department visits captured in NSSP were due to CLI and 0.6% were due to ILI. This is the tenth week of decline in the percentage of visits for ILI and the eighth week of declining percentage of visits for CLI. Compared to week 21, all 10 HHS regionsexternal icon had declining percentages of visits for CLI during week 22; all 10 regions also had declining or stable percentages of visits for ILI.



                        Additional information about medically attended outpatient and emergency department visits for ILI and CLI: Surveillance Methods


                        Hospitalizations


                        The COVID-19-Associated Hospitalization Surveillance Network (COVID-NET) conducts population-based surveillance for laboratory-confirmed COVID-19-associated hospitalizations in select counties participating in the Emerging Infections Program (EIP) and the Influenza Hospitalization Surveillance Project (IHSP).

                        A total of 26,623 laboratory-confirmed COVID-19-associated hospitalizations were reported by sites between March 1, 2020, and May 30, 2020. The overall cumulative hospitalization rate was 82.0 per 100,000 population. Among the 0-4 years, 5-17 years, 18-49 years, 50-64 years, and ≥ 65 years age groups, the highest rate of hospitalization is among adults aged ≥ 65 years (254.7 per 100,000), followed by adults aged 50-64 years (126.2 per 100,000) and adults aged 18-49 years (46.7 per 100,000).

                        resize iconView Larger
                        Within the 18-49 years and ≥ 65 years age groups, the cumulative hospitalization rates increased with increasing age.
                        Overall 82.0
                        0-4 years 4.9
                        5-17 years 2.4
                        18-49 years 46.7
                        18-29 years 23.7
                        30-39 years 46.2
                        40-49 years 77.1
                        50-64 years 126.2
                        65+ years 254.7
                        65-74 years 185.7
                        75-84 years 307.5
                        85+ years 470.6
                        Among the 0-4 years and 5-17 years age groups, there appears to be a slight upward trend in weekly hospitalization rates, though these rates are limited by smaller case counts and may change as additional data are received. Weekly rates in the 18-29 years age group have been holding steady, while weekly rates have been declining in all other age groups.

                        Among the 26,623 laboratory-confirmed COVID-19-associated hospitalized cases, 21,282 (79.9%) had information available on race and ethnicity while collection of race and ethnicity data was still pending for 5,341 (20.1%) cases. Of the 21,282 cases with race and ethnicity data, 35.5% were non-Hispanic White, 33.5% were non-Hispanic Black, 18.2% were Hispanic or Latino, 4.7% were non-Hispanic Asian or Pacific Islander, and 1.5% were non-Hispanic American Indian and or Alaska Native persons. Persons of multiple races represented 0.2% of cases, and 6.4% of cases had unknown race and ethnicity. In comparison, the COVID-NET catchment area population includes 58.8% non-Hispanic White, 17.7% non-Hispanic Black, 14.0% Hispanic or Latino, 8.8% non-Hispanic Asian or Pacific Islander, and 0.7% non-Hispanic American Indian or Alaska Native residents. Additional data on race and ethnicity are available.

                        COVID-19-associated hospitalization rates by race/ethnicity are calculated using hospitalized COVID-NET cases with known race and ethnicity for the numerator and NCHS bridged-race population estimates for the denominator. Rates are adjusted to account for differences in age distributions within race/ethnicity strata in the COVID-NET catchment area; the age strata used for the adjustment include 0-17, 18-49, 50-64, 65-74, 75-84, and ≥ 85 years. Age-adjusted hospitalization rates are highest among non-Hispanic American Indian or Alaska Native and non-Hispanic Black persons, followed by Hispanic or Latino persons. Non-Hispanic American Indian or Alaska Native persons have a rate approximately 5 times that of non-Hispanic White persons, non-Hispanic Black persons have a rate approximately 4.5 times that of non-Hispanic White persons, while Hispanics or Latinos persons have a rate approximately 3.5 times that of non-Hispanic White persons.

                        Among 6,000 hospitalized adults with information on underlying medical conditions, 91.6% had at least one reported underlying medical condition. The most commonly reported were hypertension, obesity, chronic metabolic disease, and cardiovascular disease.

                        resize iconView Larger


                        Additional data on demographics, signs and symptoms at admission, underlying conditions, interventions, outcomes, and discharge diagnoses, stratified by age, sex, and race and ethnicity, are available.

                        Additional hospitalization surveillance information: Surveillance Methods | Additional rate data | Additional demographic and clinical data


                        Mortality Surveillance


                        The National Center for Health Statistics (NCHS) collects death certificate data from vital statistics offices for all deaths occurring in the United States. Based on death certificate data available on June 4, 2020, 8.4% of all deaths occurring during the week ending May 30, 2020 (week 22) were due to pneumonia, influenza or COVID-19 (PIC). This is the sixth week of a declining percentage of deaths due to PIC; however, the percentage remains above the epidemic threshold of 6.3% for week 22. Data for recent weeks are incomplete, and the PIC percentage may increase as more death certificates representing deaths during these weeks are processed.

                        Weekly mortality surveillance data include a combination of machine coded and manually coded causes of death collected from death certificates. Percentages of deaths due to PIC are higher among manually coded records than more rapidly available machine coded records. Due to the additional time needed for manual coding, the initially reported PIC percentages may be lower than percentages calculated from final data.

                        resize iconView Larger


                        *Data during recent weeks are incomplete because of the lag in time between when the death occurred and when the death certificate is completed, submitted to NCHS and processed for reporting purposes.
                        View Data Table


                        Additional NCHS mortality surveillance information: Surveillance Methods | Provisional Death Counts for COVID-19

                        More Information
                        View Page In:pdf icon 49 Pages, 3 MB
                        Page last reviewed: June 5, 2020
                        Content source: National Center for Immunization and Respiratory Diseases (NCIRD), Division of Viral DiseaseshomeCoronavirus Disease 2019 (COVID-19)email_03Get Email Updates

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                        Twitter: @RonanKelly13
                        The views expressed are mine alone and do not represent the views of my employer or any other person or organization.

                        Comment


                        • #13
                          COVIDView: A Weekly Surveillance Summary of U.S. COVID-19 Activity


                          Print Page
                          Updated June 12, 2020

                          Download Weekly Summary pdf icon[47 Pages, 2 MB]
                          Key Updates for Week 23, ending June 6, 2020


                          Nationally, levels of influenza-like illness (ILI) and COVID-19-like illness (CLI) continue to decline or remain stable at low levels. The percentage of specimens testing positive for SARS-CoV-2, the virus that causes COVID-19, increased slightly from last week. Mortality attributed to COVID-19 also decreased compared to last week but remains elevated above baseline and may increase as additional death certificates are processed.
                          Virus

                          Public Health, Commercial and Clinical Laboratories


                          The overall percentage of respiratory specimens testing positive for SARS-CoV-2 increased slightly from week 22 (6.0%) to week 23 (6.3%) nationally driven by increases in four regions. National percentages by type of laboratory:
                          • Public health laboratories – decreased from 5.8% during week 22 to 5.0% during week 23;
                          • Clinical laboratories – decreased from 5.5% during week 22 to 5.3% during week 23;
                          • Commercial laboratories – increased from 6.1% during week 22 to 6.5% during week 23.
                          Outpatient and Emergency Department Visits

                          Outpatient Influenza-Like Illness Network (ILINet) and National Syndromic Surveillance Program (NSSP)


                          Two surveillance indicators are being used to track outpatient or emergency department (ED) visits for illness with symptoms compatible with COVID-19.
                          • Nationally, the percentages of visits for ILI and CLI decreased or remained stable at low levels, compared to last week. Levels of ILI are below baseline nationally for the eighth week and in all 10 surveillance regions for the past six to nine weeks.

                          Recent changes in health care seeking behavior, including increasing use of telemedicine, recommendations to limit emergency department (ED) visits to severe illnesses, and increased practice of social distancing, are likely affecting data reported from both networks, making it difficult to draw conclusions at this time. Tracking these systems moving forward will give additional insight into illness related to COVID-19.
                          Severe Disease

                          Hospitalizations


                          Cumulative COVID-19-associated hospitalization rates since March 1, 2020, are updated weekly. The overall cumulative COVID-19 hospitalization rate is 89.3 per 100,000, with the highest rates in people aged 65 years and older (273.8 per 100,000) and 50-64 years (136.1 per 100,000).
                          Mortality


                          Based on death certificate data, the percentage of deaths attributed to pneumonia, influenza or COVID-19 (PIC) decreased from 12.4% during week 22 to 7.3% during week 23 but remained above baseline. This is the seventh week of a declining percentage of deaths due to PIC, but this percentage may change as more death certificates are processed, particularly for recent weeks.

                          All data are preliminary and may change as more reports are received.

                          A description of the surveillance systems summarized in COVIDView, including methodology and detailed descriptions of each data component, is available on the surveillance methods page.
                          Key Points
                          • Nationally, using combined data from the three laboratory types, the percentages of laboratory specimens testing positive for SARS-CoV-2 with a molecular assay increased slightly compared to last week.
                            • The national increase was driven by increases in four HHS surveillance regions: Region 2 (North East), Region 4 (South East), Region 6 (South Central), and Region 10 (Pacific Northwest).
                            • While the number of specimens from children <18 years of age tested is low (<5% of all specimens tested in public health and commercial laboratories), the percentage testing positive for SARS-CoV-2 in this age group is higher than it is in the adult age groups.
                          • While the number of COVID-19 cases reported to CDC is cumulative and continues to increase, nationally, the proportion of visits to outpatient providers and emergency departments (EDs) for illnesses with symptoms consistent with COVID-19 continued to decline or remain stable at low levels. Outpatient ILI visits are below baseline nationally and in all regions of the country.
                            • The low levels of people presenting for care with ILI and CLI may reflect low levels of COVID-19 and other respiratory illness, which could be in part a result of widespread adoption of social distancing, in addition to changes in healthcare seeking behavior.
                            • There has been very little influenza virus activity in recent weeks.
                          • The overall cumulative COVID-19 associated hospitalization rate is 89.3 per 100,000, with the highest rates in people 65 years of age and older (273.8 per 100,000) followed by people 50-64 years (136.1 per 100,000). Hospitalization rates are cumulative and will increase as the COVID-19 pandemic continues.
                            • Non-Hispanic American Indian or Alaska Native persons have a rate approximately 5 times that of non-Hispanic White persons, non-Hispanic Black persons have a rate approximately 4.5 times that of non-Hispanic White persons, and Hispanic or Latino persons have a rate approximately 4 times that of non-Hispanic White persons.
                            • Cumulative hospitalization rates for COVID-19 in adults (18-64 years) at this time are higher than cumulative end-of-season hospitalization rates for influenza over each of the past 5 influenza seasons.
                            • For people 65 years and older, current cumulative COVID-19 hospitalization rates are within ranges of cumulative influenza hospitalization rates observed at comparable time points* during recent influenza seasons.
                            • For children (0-17 years), cumulative COVID-19 hospitalization rates are much lower than cumulative influenza hospitalization rates at comparable time points* during recent influenza seasons.
                          • Based on death certificate data, the percentage of deaths attributed to pneumonia, influenza or COVID-19 (PIC) decreased from 12.4% during week 22 to 7.3% during week 23. This is the seventh week during which a declining percentage of deaths due to PIC has been recorded; however, the percentage remains above the epidemic threshold. The percentage may change as additional death certificates for deaths during recent weeks are processed.

                          *Number of weeks since 10% of specimens tested positive for SARS-CoV-2 and influenza, respectively.

                          U.S. Virologic Surveillance


                          The number of specimens tested for SARS-CoV-2 using a molecular assay and reported to CDC by public health laboratories and a subset of clinical and commercial laboratories in the United States are summarized below. All laboratories are performing primary diagnostic functions; therefore, the percentage of specimens testing positive across laboratory types can be used to monitor overall trends in COVID-19 activity. As the outbreak progresses, it is possible that different types of laboratories will take on different roles, and the data interpretation may need to change.
                          1,587,072 12,604,300
                          189,815 1,650,462
                          105,670 1,089,500
                          1,291,587 9,864,338
                          99,357 (6.3%) 1,379,860 (10.9%)
                          9,543 (5.0%) 174,716 (10.6%)
                          5,593 (5.3%) 83,910 (7.7%)
                          84,221 (6.5%) 1,121,234 (11.4%)
                          * Commercial and clinical laboratory data represents select laboratories and does not capture all tests performed in the United States.
                          Public Health Laboratories


                          resize iconView LargerView Data Table

                          Clinical Laboratories


                          resize iconView LargerView Data Table

                          Commercial Laboratories


                          resize iconView Larger


                          * Commercial laboratories began testing for SARS-CoV-2 in early March, but the number and geographic distribution of reporting commercial laboratories became stable enough to calculate a weekly percentage of specimens testing positive as of March 29, 2020.
                          View Data Table


                          Additional virologic surveillance information: Surveillance Methods


                          Outpatient/Emergency Department Illness


                          Two syndromic surveillance systems are being used to monitor trends in outpatient and emergency department visits that may be associated with COVID-19 illness. Each system monitors a slightly different syndrome, and together these systems provide a more comprehensive picture of mild to moderate COVID-19 illness than either would individually. Both systems are currently being affected by recent changes in healthcare seeking behavior, including increased use of telemedicine, compliance with recommendations to limit emergency department (ED) visits to severe illnesses, and increased practice of social distancing. These changes affect the numbers of people seeking care in the outpatient and ED settings and their reasons for doing so.
                          ILINet


                          The U.S. Outpatient Influenza-like Illness Surveillance Network (ILINet) provides data on visits for influenza-like illness (ILI) (fever [≥100F] and cough and/or sore throat) to approximately 2,600 primary care providers, emergency departments and urgent care centers in all 50 states, Puerto Rico, the District of Columbia and the U.S. Virgin Islands. Mild COVID-19 illness presents with symptoms similar to ILI, so ILINet is being used to track trends of mild to moderate COVID-19 illness and allows for comparison with prior influenza seasons.

                          Nationwide during week 23, 0.7% of patient visits reported through ILINet were due to ILI. This percentage is well below the national baseline of 2.4% and represents the eleventh week of decline after three weeks of increase beginning in early March. The percentage of visits for ILI in week 23 remains low among all age groups. Nationally, laboratory-confirmed influenza activity as reported by clinical laboratories is at levels usually seen during summer months which, along with changes in healthcare seeking behavior and the impact of social distancing, is likely contributing to the low level of ILI activity.

                          resize iconView Larger


                          * Age-group specific percentages should not be compared to the national baseline.

                          On a regional levelexternal icon, the percentage of outpatient visits for ILI ranged from 0.4% to 1.1% during week 23. All ten regions are at low levels and below their region-specific baselines.

                          Note: In response to the COVID-19 pandemic, new sites will be enrolled in ILINet throughout the summer. This will result in an increase in patient visits and the percentage of visits for ILI may change in comparison to previous weeks. During week 21, new sites were added in Regions 1, 4, and 6. While these regions remain below baseline levels for ILI, these system changes should be kept in mind when drawing conclusions from these data. Any changes in ILI due to changes in respiratory virus circulation will be highlighted in this report.
                          Overall Percentage of Visits for ILI | Age Group ILI Data

                          ILI Activity Levels


                          Data collected in ILINet are used to produce a measure of ILI activity for all 50 states, Puerto Rico, the District of Columbia and New York City. The mean reported percentage of visits due to ILI for the current week is compared to the mean reported during non-influenza weeks, and the activity levels correspond to the number of standard deviations below, at or above the mean.

                          The number of jurisdictions at each activity level during week 23 and the change compared to the previous week are summarized in the table below and shown in the following maps. The decreasing percentage of visits for ILI described above are reflected in this week’s ILI activity levels.
                          Activity Level Number of Jurisdictions
                          Week 23
                          (Week ending June 6, 2020)
                          Compared to Previous Week
                          Very High 0 No change
                          High 0 No change
                          Moderate 0 -1
                          Low 1 No change
                          Minimal 52 +1
                          Insufficient Data 1 No change
                          *Data collected in ILINet may disproportionally represent certain populations within a state and may not accurately depict the full picture of influenza activity for the whole state. Differences in the data presented here by CDC and independently by some state health departments likely represent differing levels of data completeness with data presented by the state likely being the more complete.
                          National Syndromic Surveillance Program (NSSP): Emergency Department (ED) Visits


                          NSSP is a collaboration among CDC, federal partners, local and state health departments and academic and private sector partners to collect, analyze and share electronic patient encounter data received from multiple healthcare settings. To track trends of potential COVID-19 visits, visits for COVID-19-like illness (CLI) (fever and cough or shortness of breath or difficulty breathing or presence of a coronavirus diagnosis code) and ILI to a subset of emergency departments in 47 states are being monitored.

                          Nationwide during week 23, 1.6% of emergency department visits captured in NSSP were due to CLI and 0.6% were due to ILI. This is the eleventh week of declining or stable percentage of visits for ILI and the ninth week of declining percentage of visits for CLI. Compared to week 22, all 10 HHS regionsexternal icon had declining or stable percentages of visits for CLI during week 23; all 10 regions also had declining or stable percentages of visits for ILI.



                          Additional information about medically attended outpatient and emergency department visits for ILI and CLI: Surveillance Methods


                          Hospitalizations


                          The COVID-19-Associated Hospitalization Surveillance Network (COVID-NET) conducts population-based surveillance for laboratory-confirmed COVID-19-associated hospitalizations in select counties participating in the Emerging Infections Program (EIP) and the Influenza Hospitalization Surveillance Project (IHSP).

                          A total of 28,987 laboratory-confirmed COVID-19-associated hospitalizations were reported by sites between March 1, 2020, and June 6, 2020. The overall cumulative hospitalization rate was 89.3 per 100,000 population. Among the 0-4 years, 5-17 years, 18-49 years, 50-64 years, and ≥ 65 years age groups, the highest rate of hospitalization is among adults aged 65 years (273.8 per 100,000), followed by adults aged 50-64 years (136.1 per 100,000) and adults aged 18-49 years (52.4 per 100,000).

                          resize iconView Larger
                          Overall 89.3
                          0-4 years 5.6
                          5-17 years 3.1
                          18-49 years 52.4
                          18-29 years 27.3
                          30-39 years 52.5
                          40-49 years 84.6
                          50-64 years 136.1
                          65+ years 273.8
                          65-74 years 198.7
                          75-84 years 329.3
                          85+ years 513.2
                          Among the 28,987 laboratory-confirmed COVID-19-associated hospitalized cases, 24,936 (86.0%) had information on race and ethnicity, while collection of race and ethnicity was still pending for 4,051 (14.0%) cases. Of the 24,936 cases with race and ethnicity data, 34.2% were non-Hispanic White, 32.9% were non-Hispanic Black, 20.2% were Hispanic or Latino, 4.6% were non-Hispanic Asian or Pacific Islander, and 1.5% were non-Hispanic American Indian or Alaska Native persons. Persons of multiple races represented 0.2% of cases, and 6.4% of cases had unknown race and ethnicity. In comparison, the COVID-NET catchment area population includes 58.8% non-Hispanic White, 17.7% non-Hispanic Black, 14.0% Hispanic or Latino, 8.8% non-Hispanic Asian or Pacific Islander, and 0.7% non-Hispanic American Indian or Alaska Native residents. Additional data on race and ethnicity are available.

                          COVID-19-associated hospitalization rates by race/ethnicity are calculated using hospitalized COVID-NET cases with known race and ethnicity for the numerator and NCHS bridged-race population estimates for the denominator. Rates are adjusted to account for differences in age distributions within race/ethnicity strata in the COVID-NET catchment area; the age strata used for the adjustment include 0-17, 18-49, 50-64, 65-74, 75-84, and ≥ 85 years. Age-adjusted hospitalization rates are highest among non-Hispanic American Indian or Alaska Native and non-Hispanic Black persons, followed by Hispanic or Latino persons. Non-Hispanic American Indian or Alaska Native persons have a rate approximately 5 times that of non-Hispanic White persons, non-Hispanic Black persons have a rate approximately 4.5 times that of non-Hispanic White persons, while Hispanic or Latino persons have a rate approximately 4 times that of non-Hispanic White persons.

                          Among 6,693 hospitalized adults with information on underlying medical conditions, 91.5% had at least one reported underlying medical condition. The most commonly reported were hypertension, obesity, chronic metabolic disease, and cardiovascular disease. Among 128 hospitalized children with information on underlying conditions, 53.1% had at least one reported underlying medical condition. The most commonly reported condition was obesity.

                          resize iconView Larger


                          Additional data on demographics, signs and symptoms at admission, underlying conditions, interventions, outcomes, and discharge diagnoses, stratified by age, sex, and race and ethnicity, are available.

                          Additional hospitalization surveillance information: Surveillance Methods | Additional rate data | Additional demographic and clinical data


                          Mortality Surveillance


                          The National Center for Health Statistics (NCHS) collects death certificate data from vital statistics offices for all deaths occurring in the United States. Based on death certificate data available on June 11, 2020, 7.3% of all deaths occurring during the week ending June 6, 2020 (week 23) were due to pneumonia, influenza or COVID-19 (PIC). This is the seventh week of a declining percentage of deaths due to PIC; however, the percentage remains above the epidemic threshold of 6.2% for week 23. Data for recent weeks are incomplete, and the PIC percentage may increase as more death certificates representing deaths during these weeks are processed.

                          Weekly mortality surveillance data include a combination of machine coded and manually coded causes of death collected from death certificates. Percentages of deaths due to PIC are higher among manually coded records than more rapidly available machine coded records. Due to the additional time needed for manual coding, the initially reported PIC percentages may be lower than percentages calculated from final data.

                          resize iconView Larger


                          *Data during recent weeks are incomplete because of the lag in time between when the death occurred and when the death certificate is completed, submitted to NCHS and processed for reporting purposes.
                          View Data Table


                          Additional NCHS mortality surveillance information: Surveillance Methods | Provisional Death Counts for COVID-19

                          More Information
                          View Page In:pdf icon 49 Pages, 3 MB
                          Page last reviewed: June 12, 2020
                          Content source: National Center for Immunization and Respiratory Diseases (NCIRD), Division of Viral Diseases


                          https://www.cdc.gov/coronavirus/2019...iew/index.html
                          Twitter: @RonanKelly13
                          The views expressed are mine alone and do not represent the views of my employer or any other person or organization.

                          Comment


                          • #14
                            COVIDView: A Weekly Surveillance Summary of U.S. COVID-19 Activity


                            Print Page
                            Download Weekly Summary pdf icon[49 Pages, 2.45 MB]
                            Key Updates for Week 25, ending June 20, 2020


                            Nationally, levels of influenza-like illness (ILI) and COVID-19-like illness (CLI) remain lower than peaks seen in March and April but are increasing in several regions. The percentage of specimens testing positive for SARS-CoV-2, the virus that causes COVID-19, also increased from last week. Mortality attributed to COVID-19 decreased compared to last week but remains elevated above baseline and may increase as additional death certificates are processed.
                            Virus

                            Public Health, Commercial and Clinical Laboratories


                            The overall percentage of respiratory specimens testing positive for SARS-CoV-2 increased from week 24 (6.5%) to week 25 (7.6%) nationally, driven by increases in seven regions. National percentages by type of laboratory:
                            • Public health laboratories – increased from 5.2% during week 24 to 6.1% during week 25;
                            • Clinical laboratories – increased from 4.7% during week 24 to 5.2% during week 25;
                            • Commercial laboratories – increased from 6.9% during week 24 to 7.9% during week 25.
                            Outpatient and Emergency Department Visits

                            Outpatient Influenza-Like Illness Network (ILINet) and National Syndromic Surveillance Program (NSSP)


                            Two surveillance indicators are being used to track outpatient or emergency department (ED) visits for illness with symptoms compatible with COVID-19.
                            • Nationally, levels of ILI remain below baseline for the tenth week and in all 10 surveillance regions for the past eight to eleven weeks. However, several regions reported increases in percentage of visits for ILI and CLI.
                            • Recent changes in health care seeking behavior, including increasing use of telemedicine, recommendations to limit emergency department (ED) visits to severe illnesses, and increased practice of social distancing, are likely affecting data reported from both networks, making it difficult to draw conclusions at this time. Tracking these systems moving forward will give additional insight into illness related to COVID-19.
                            Severe Disease

                            Hospitalizations


                            Cumulative COVID-19-associated hospitalization rates since March 1, 2020, are updated weekly. The overall cumulative COVID-19 hospitalization rate is 98.4 per 100,000, with the highest rates in people aged 65 years and older (297.6 per 100,000) and 50-64 years (148.6 per 100,000).
                            Mortality


                            Based on death certificate data, the percentage of deaths attributed to pneumonia, influenza or COVID-19 (PIC) decreased from 9.5% during week 24 to 6.9% during week 25 but remained above baseline. This is the ninth week of a declining percentage of deaths due to PIC, but this may change as more death certificates are processed, particularly for recent weeks.

                            All data are preliminary and may change as more reports are received.

                            A description of the surveillance systems summarized in COVIDView, including methodology and detailed descriptions of each data component, is available on the surveillance methods page.
                            Key Points
                            • Overall, indicators used to monitor COVID-19 activity remain lower than peaks seen in March and April; however, increases are being seen in the percentage of specimens testing positive for SARS-CoV-2 and percentage of visits for ILI or CLI in multiple parts of the country, in some case for consecutive weeks.
                            • Nationally, using combined data from the three laboratory types, the percentages of laboratory specimens testing positive for SARS-CoV-2 with a molecular assay increased from week 24 (6.5%) to week 25 (7.6%).
                              • Increases were reported in seven of ten HHS surveillance regions, three of which (Region 4 [South East], Region 6 [South Central], and Region 9 [South West/Coast]) reported >10% of specimens positive for SARS-CoV-2.
                              • Three regions (Region 1 [New England], Region 3 [Mid-Atlantic] and Region 5 [Midwest]), reported a decrease in percentage of specimens testing positive for SARS-CoV-2.
                            • The percentage of outpatient and emergency department visits for ILI are below baseline nationally and in all regions of the country. Most regions have remained stable, compared to last week; however, a few regions experienced an increase in the percentage of visits for CLI and/or ILI with the largest increases in Regions 4 (South East), 6 (South Central), and 9 (South West/Coast).
                              • Systems monitoring ILI and CLI may be influenced by recent changes in health care seeking behavior, including increasing use of telemedicine, recommendations to limit emergency department (ED) visits to severe illnesses, and increased practice of social distancing.
                            • The overall cumulative COVID-19 associated hospitalization rate is 98.4 per 100,000, with the highest rates in people 65 years of age and older (297.6 per 100,000) followed by people 50-64 years (148.6 per 100,000). Hospitalization rates are cumulative and will increase as the COVID-19 pandemic continues.
                              • Non-Hispanic American Indian or Alaska Native persons have an age-adjusted hospitalization rate approximately 5 times that of non-Hispanic White persons, while non-Hispanic Black persons and Hispanic or Latino persons each have a rate approximately 4.5 times that of non-Hispanic White persons.
                              • Cumulative hospitalization rates for COVID-19 in adults (18-64 years) at this time are higher than cumulative end-of-season hospitalization rates for influenza over each of the past 5 influenza seasons.
                              • For people 65 years and older, current cumulative COVID-19 hospitalization rates are within ranges of cumulative influenza hospitalization rates observed at comparable time points* during recent influenza seasons.
                              • For children (0-17 years), cumulative COVID-19 hospitalization rates are much lower than cumulative influenza hospitalization rates at comparable time points* during recent influenza seasons.
                            • Based on death certificate data, the percentage of deaths attributed to pneumonia, influenza or COVID-19 (PIC) decreased from 9.5% during week 24 to 6.9% during week 25. This is the ninth week during which a declining percentage of deaths due to PIC has been recorded; however, the percentage remains above the epidemic threshold. The percentage may change as additional death certificates for deaths during recent weeks are processed.

                            *Number of weeks since 10% of specimens tested positive for SARS-CoV-2 and influenza, respectively.

                            U.S. Virologic Surveillance


                            The number of specimens tested for SARS-CoV-2 using a molecular assay and reported to CDC by public health laboratories and a subset of clinical and commercial laboratories in the United States are summarized below. All laboratories are performing primary diagnostic functions; therefore, the percentage of specimens testing positive across laboratory types can be used to monitor overall trends in COVID-19 activity. As the outbreak progresses, it is possible that different types of laboratories will take on different roles, and the data interpretation may need to change.
                            1,772,631 16,998,825
                            172,748 2,101,748
                            117,732 1,434,393
                            1,482,151 13,462,684
                            133,899 (7.6%) 1,677,604 (9.9%)
                            10,474 (6.1%) 199,744 (9.5%)
                            6,162 (5.2%) 96,572 (6.7%)
                            117,263 (7.9%) 1,381,288 (10.3%)
                            * Commercial and clinical laboratory data represents select laboratories and does not capture all tests performed in the United States.
                            Public Health Laboratories


                            resize iconView LargerView Data Table

                            Clinical Laboratories


                            resize iconView LargerView Data Table

                            Commercial Laboratories


                            resize iconView Larger


                            * Commercial laboratories began testing for SARS-CoV-2 in early March, but the number and geographic distribution of reporting commercial laboratories became stable enough to calculate a weekly percentage of specimens testing positive as of March 29, 2020.
                            View Data Table


                            Additional virologic surveillance information: Surveillance Methods


                            Outpatient/Emergency Department Illness


                            Two syndromic surveillance systems are being used to monitor trends in outpatient and emergency department visits that may be associated with COVID-19 illness. Each system monitors a slightly different syndrome, and together these systems provide a more comprehensive picture of mild to moderate COVID-19 illness than either would individually. Both systems are currently being affected by recent changes in healthcare seeking behavior, including increased use of telemedicine, compliance with recommendations to limit emergency department (ED) visits to severe illnesses, and increased practice of social distancing. These changes affect the numbers of people seeking care in the outpatient and ED settings and their reasons for doing so.
                            ILINet


                            The U.S. Outpatient Influenza-like Illness Surveillance Network (ILINet) provides data on visits for influenza-like illness (ILI) (fever [≥100F] and cough and/or sore throat) to approximately 2,600 primary care providers, emergency departments and urgent care centers in all 50 states, Puerto Rico, the District of Columbia and the U.S. Virgin Islands. Mild COVID-19 illness presents with symptoms similar to ILI, so ILINet is being used to track trends of mild to moderate COVID-19 illness and allows for comparison with prior influenza seasons.

                            Nationwide during week 25, 0.8% of patient visits reported through ILINet were due to ILI. This percentage is well below the national baseline of 2.4%. The percentage of visits for ILI in week 25 remains low among all age groups but increased slightly for persons less than 65 years of age. Nationally, laboratory-confirmed influenza activity as reported by clinical laboratories is at levels usually seen during summer months which, along with changes in healthcare seeking behavior and the impact of social distancing, is likely contributing to the low level of ILI activity.

                            resize iconView Larger


                            * Age-group specific percentages should not be compared to the national baseline.

                            On a regional levelexternal icon, the percentage of outpatient visits for ILI ranged from 0.4% to 1.4% during week 25. All ten regions are at low levels and below their region-specific baselines; however, Region 4 (South East) increased from 0.9% during week 24 to 1.3% during week 25; Regions 7 (Central), 8 (West) and 9 (South West/Coast) also reported slight increases.

                            Note: In response to the COVID-19 pandemic, new data sources will be incorporated into ILINet as we move into summer weeks when lower levels of influenza and other respiratory virus circulation are typical. Starting in week 21, increases in the number of patient visits will be seen as new sites are enrolled and the percentage of visits for ILI may change in comparison to previous weeks. While all regions remain below baseline levels for ILI, these system changes should be kept in mind when drawing conclusions from these data. Any changes in ILI due to changes in respiratory virus circulation will be highlighted here.
                            Overall Percentage of Visits for ILI | Age Group ILI Data

                            ILI Activity Levels


                            Data collected in ILINet are used to produce a measure of ILI activity for all 50 states, Puerto Rico, the District of Columbia and New York City. The mean reported percentage of visits due to ILI for the current week is compared to the mean reported during non-influenza weeks, and the activity levels correspond to the number of standard deviations below, at or above the mean.

                            The number of jurisdictions at each activity level during week 25 and the change compared to the previous week are summarized in the table below and shown in the following maps. The decreasing percentage of visits for ILI described above are reflected in this week’s ILI activity levels.
                            Activity Level Number of Jurisdictions
                            Week 25
                            (Week ending
                            June 20, 2020)
                            Compared to Previous Week
                            Very High 0 No change
                            High 0 No change
                            Moderate 0 No change
                            Low 1 +1
                            Minimal 51 -2
                            Insufficient Data 2 +1
                            *Data collected in ILINet may disproportionally represent certain populations within a state and may not accurately depict the full picture of influenza activity for the whole state. Differences in the data presented here by CDC and independently by some state health departments likely represent differing levels of data completeness with data presented by the state likely being the more complete.
                            National Syndromic Surveillance Program (NSSP): Emergency Department (ED) Visits


                            NSSP is a collaboration among CDC, federal partners, local and state health departments and academic and private sector partners to collect, analyze and share electronic patient encounter data received from multiple healthcare settings. To track trends of potential COVID-19 visits, visits for COVID-19-like illness (CLI) (fever and cough or shortness of breath or difficulty breathing or presence of a coronavirus diagnosis code) and ILI to a subset of emergency departments in 47 states are being monitored.

                            Nationwide during week 25, 2.1% of emergency department visits captured in NSSP were due to CLI and 0.8% were due to ILI. This is the first week of an increasing percentage of visits for CLI and ILI nationally since activity peaked in early April. Compared to week 24, 3 of 10 HHS regionsexternal icon (Regions 4 [South East], 6 [South Central] and 9 [South West/Coast]) reported increases in the percentages of visits for both CLI and ILI during week 25. One additional region reported a slight increase in percentage of visits for CLI during week 25 (Region 8 [Mountain]) and 2 additional regions reported a slight increase in percentage of visits for ILI (Regions 3 [Mid-Atlantic] and 7 [Central]).



                            Additional information about medically attended outpatient and emergency department visits for ILI and CLI: Surveillance Methods


                            Hospitalizations


                            The COVID-19-Associated Hospitalization Surveillance Network (COVID-NET) conducts population-based surveillance for laboratory-confirmed COVID-19-associated hospitalizations in select counties participating in the Emerging Infections Program (EIP) and the Influenza Hospitalization Surveillance Project (IHSP).

                            A total of 31,934 laboratory-confirmed COVID-19-associated hospitalizations were reported by sites between March 1, 2020 and June 20, 2020. The overall cumulative hospitalization rate was 98.4 per 100,000 population. Among the 0-4 years, 5-17 years, 18-49 years, 50-64 years, and ≥ 65 years age groups, the highest rate of hospitalization is among adults aged ≥ 65 years, followed by adults aged 50-64 years and adults aged 18-49 years.

                            resize iconView Larger
                            Overall 98.4
                            0-4 years 8.0
                            5-17 years 3.7
                            18-49 years 59.2
                            18-29 years 32.1
                            30-39 years 59.2
                            40-49 years 94.1
                            50-64 years 148.6
                            65+ years 297.6
                            65-74 years 216.3
                            75-84 years 358.2
                            85+ years 556.2
                            Among the 31,934 laboratory-confirmed COVID-19-associated hospitalized cases, 29,789 (93.3%) had information on race and ethnicity while collection of race and ethnicity was still pending for 2,145 (6.7%) cases. Non-Hispanic American Indian or Alaska Native persons have an age-adjusted hospitalization rate approximately 5 times that of non-Hispanic White persons, while non-Hispanic Black persons and Hispanic or Latino persons each have a rate approximately 4.5 times that of non-Hispanic White persons. Additional data on race and ethnicity are available.



                            Non-Hispanic White persons represent the highest proportion of hospitalized cases reported to COVID-NET, followed by non-Hispanic Black, Hispanic or Latino, non-Hispanic Asian or Pacific Islander, and non-Hispanic American Indian or Alaska Native persons. However, some racial and ethnic groups are disproportionately represented among hospitalized cases as compared with the overall population of the catchment area. Prevalence ratios show a similar pattern to that of the age-adjusted hospitalization rates: non-Hispanic American Indian or Alaska Native persons have the highest prevalence ratio, followed by non-Hispanic Black, and Hispanic or Latino persons.
                            231.0 202.2 192.8 54.2 43.5
                            1.5% 32.6% 22.0% 4.7% 32.8%
                            0.7% 17.7% 14.0% 8.8% 58.8%
                            2.1 1.8 1.5 0.5 0.6
                            1COVID-19-associated hospitalization rates by race/ethnicity are calculated using hospitalized COVID-NET cases with known race and ethnicity for the numerator and NCHS bridged-race population estimates NCHS bridged-race population estimates for the denominator. Rates are adjusted to account for differences in age distributions within race/ethnicity strata in the COVID-NET catchment area; the age strata used for the adjustment include 0-17, 18-49, 50-64, 65-74, 75-84, and 85 years.

                            2 Persons of multiple races (0.2%) or unknown race and ethnicity (6.2%) are not represented in the table but are included as part of the denominator.

                            3 Prevalence ratio is calculated as the ratio of the proportion of hospitalized COVID-NET cases over the proportion of population in COVID-NET catchment area.

                            Among 8,089 hospitalized adults with information on underlying medical conditions, 91% had at least one reported underlying medical condition. The most commonly reported were hypertension, obesity, chronic metabolic disease, and cardiovascular disease. Among 158 hospitalized children with information on underlying conditions, 53.2% had at least one reported underlying medical condition. The most commonly reported were obesity, asthma, and neurologic conditions.

                            resize iconView Larger


                            Additional data on demographics, signs and symptoms at admission, underlying conditions, interventions, outcomes, and discharge diagnoses, stratified by age, sex, and race and ethnicity, are available.

                            Additional hospitalization surveillance information: Surveillance Methods | Additional rate data | Additional demographic and clinical data


                            Mortality Surveillance


                            The National Center for Health Statistics (NCHS) collects death certificate data from vital statistics offices for all deaths occurring in the United States. Based on death certificate data available on June 25, 2020, 6.9% of all deaths occurring during the week ending June 20, 2020 (week 25) were due to pneumonia, influenza or COVID-19 (PIC). This is the ninth week of a declining percentage of deaths due to PIC; however, the percentage remains above the epidemic threshold of 5.9% for week 25. Data for recent weeks are incomplete, and the PIC percentage may increase as more death certificates representing deaths during these weeks are processed.

                            Weekly mortality surveillance data include a combination of machine coded and manually coded causes of death collected from death certificates. Percentages of deaths due to PIC are higher among manually coded records than more rapidly available machine coded records. Due to the additional time needed for manual coding, the initially reported PIC percentages may be lower than percentages calculated from final data.

                            resize iconView Larger


                            *Data during recent weeks are incomplete because of the lag in time between when the death occurred and when the death certificate is completed, submitted to NCHS and processed for reporting purposes.
                            View Data Table


                            Additional NCHS mortality surveillance information: Surveillance Methods | Provisional Death Counts for COVID-19

                            More Information
                            View Page In:pdf icon 49 Pages, 2.45 MB
                            Page last reviewed: June 26, 2020
                            Content source: National Center for Immunization and Respiratory Diseases (NCIRD), Division of Viral DiseaseshomeCoronavirus Disease 2019 (COVID-19)email_03Get Email Updates

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                            Spanish Resourceshttps://www.cdc.gov/coronavirus/2019...iew/index.html
                            Twitter: @RonanKelly13
                            The views expressed are mine alone and do not represent the views of my employer or any other person or organization.

                            Comment


                            • #15
                              1. CASES, DATA & SURVEILLANCE
                              COVIDView: A Weekly Surveillance Summary of U.S. COVID-19 Activity


                              Updated July 3, 2020
                              Print
                              Download Weekly Summary pdf icon[49 Pages, 2.45 MB]
                              Key Updates for Week 26, ending June 27, 2020


                              Nationally, levels of influenza-like illness (ILI) and COVID-19-like illness (CLI) activity remain lower than peaks seen in March and April but are increasing in most regions. The percentage of specimens testing positive for SARS-CoV-2, the virus that causes COVID-19, also increased from last week. Mortality attributed to COVID-19 decreased compared to last week and is currently at the epidemic threshold but will likely increase as additional death certificates are processed.
                              Virus

                              Public Health, Commercial and Clinical Laboratories


                              The overall percentage of respiratory specimens testing positive for SARS-CoV-2 increased from week 25 (8.1%) to week 26 (8.7%) nationally, driven by increases in seven regions. National percentages of specimens testing positive for SARS-CoV-2 by type of laboratory:
                              • Public health laboratories – increased from 5.6% during week 25 to 6.3% during week 26;
                              • Clinical laboratories – increased from 5.3% during week 25 to 5.8% during week 26;
                              • Commercial laboratories – increased from 8.7% during week 25 to 9.3% during week 26.
                              Outpatient and Emergency Department Visits

                              Outpatient Influenza-Like Illness Network (ILINet) and National Syndromic Surveillance Program (NSSP)


                              Two surveillance indicators are being used to track outpatient or emergency department (ED) visits for illness with symptoms compatible with COVID-19.
                              • Nationally, levels of ILI activity remain below baseline for the eleventh week and in all 10 surveillance regions for the past nine to twelve weeks. However, most regions reported increases in percentage of visits for ILI, which is atypical for this time of year. CLI also increased the past week.
                              • Recent changes in health care seeking behavior, including increasing use of telemedicine, recommendations to limit emergency department (ED) visits to severe illnesses, and increased practice of social distancing, are likely affecting data reported from both networks, making it difficult to draw conclusions at this time. Tracking these systems moving forward will give additional insight into illness related to COVID-19.
                              Severe Disease

                              Hospitalizations


                              Cumulative COVID-19-associated hospitalization rates since March 1, 2020, are updated weekly. The overall cumulative COVID-19 hospitalization rate is 102.5 per 100,000, with the highest rates in people aged 65 years and older (306.7 per 100,000) and 50-64 years (155.0 per 100,000).
                              Mortality


                              Based on death certificate data, the percentage of deaths attributed to pneumonia, influenza or COVID-19 (PIC) decreased from 9.0% during week 25 to 5.9% during week 26, representing the tenth week of a declining percentage of deaths due to PIC. The percentage is currently at the epidemic threshold but will likely change as more death certificates are processed, particularly for recent weeks.

                              All data are preliminary and may change as more reports are received.

                              A description of the surveillance systems summarized in COVIDView, including methodology and detailed descriptions of each data component, is available on the surveillance methods page.
                              Key Points
                              • Indicators used to monitor COVID-19 activity remain lower than peaks seen in March and April; however, there are increases in the percentage of specimens testing positive for SARS-CoV-2 and percentage of visits for ILI or CLI in multiple parts of the country, which have been sustained in some cases for multiple consecutive weeks.
                              • Nationally, using combined data from the three laboratory types, the percentage of respiratory specimens testing positive for SARS-CoV-2 with a molecular assay increased from week 25 (8.1%) to week 26 (8.7%).
                                • Increases were reported in seven of ten HHS surveillance regions.
                                  • Four regions reported between 4% and 6% of specimens positive for SARS-CoV-2: Regions 2 [NY/NJ/Puerto Rico], 5 [Midwest], 7 [Central] and 10 [Pacific Northwest].
                                  • Two regions reported between 10% and 15% of specimens positive for SARS-CoV-2: Regions 4 [South East] and 9 [South West/Coast].
                                  • Region 6 [South Central] reported >15% of specimens positive for SARS-CoV-2.
                                • Three regions (Regions 1 [New England], 3 [Mid-Atlantic] and 8 [Mountain]) reported a stable or decreasing percentage of specimens testing positive for SARS-CoV-2.
                              • The percentage of outpatient and emergency department visits for ILI are below baseline nationally and in all regions of the country; however, increases in the percentage of visits for ILI and CLI were reported in seven of ten HHS surveillance regions, with the largest increases in Regions 4 (South East), 6 (South Central) and 9 (South West/Coast).
                                • Systems monitoring ILI and CLI may be influenced by recent changes in health care seeking behavior, including increasing use of telemedicine, recommendations to limit emergency department (ED) visits to severe illnesses, and increased practice of social distancing.
                              • The overall cumulative COVID-19 associated hospitalization rate is 102.5 per 100,000, with the highest rates in people 65 years of age and older (306.7 per 100,000) followed by people 50-64 years (155.0 per 100,000). Hospitalization rates are cumulative and will increase as the COVID-19 pandemic continues.
                                • Non-Hispanic American Indian or Alaska Native persons have an age-adjusted hospitalization rate approximately 5.7 times that of non-Hispanic White persons, non-Hispanic Black persons have a rate approximately 4.7 times that of non-Hispanic White persons, and Hispanic or Latino persons have a rate approximately 4.5 times that of non-Hispanic White persons.
                                • Cumulative hospitalization rates for COVID-19 in adults (18-64 years) at this time are higher than cumulative end-of-season hospitalization rates for influenza over each of the past 5 influenza seasons.
                                • For people 65 years and older, current cumulative COVID-19 hospitalization rates at this time are higher than cumulative end-of season hospitalization rates for influenza for 4 of the 5 past influenza seasons; lower only than rates observed during the 2017-18 season.
                                • For children (0-17 years), cumulative COVID-19 hospitalization rates are much lower than cumulative influenza hospitalization rates at comparable time points* during recent influenza seasons.
                              • Based on death certificate data, the percentage of deaths attributed to pneumonia, influenza or COVID-19 (PIC) decreased from 9.0% during week 25 to 5.9% during week 26, representing the tenth consecutive week during which a declining percentage of deaths due to PIC has been recorded. The percentage is currently at the epidemic threshold but will likely change as additional death certificates for deaths during recent weeks are processed.

                              *Number of weeks since 10% of specimens tested positive for SARS-CoV-2 and influenza, respectively.

                              U.S. Virologic Surveillance


                              The number of specimens tested for SARS-CoV-2 using a molecular assay and reported to CDC by public health laboratories and a subset of clinical and commercial laboratories in the United States are summarized below. All laboratories are performing primary diagnostic functions; therefore, the percentage of specimens testing positive across laboratory types can be used to monitor overall trends in COVID-19 activity. As the outbreak progresses, it is possible that different types of laboratories will take on different roles, and the data interpretation may need to change.
                              1,873,571 19,789,038
                              225,557 2,423,954
                              115,483 1,615,750
                              1,532,531 15,749,334
                              162,750 (8.7%) 1,927,728 (9.7%)
                              14,234 (6.3%) 217,831 (9.0%)
                              6,669 (5.8%) 106,653 (6.6%)
                              141,847 (9.3%) 1,603,244 (10.2%)
                              * Commercial and clinical laboratory data represents select laboratories and does not capture all tests performed in the United States.
                              Public Health Laboratories


                              resize iconView LargerView Data Table

                              Clinical Laboratories


                              resize iconView LargerView Data Table

                              Commercial Laboratories


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                              * Commercial laboratories began testing for SARS-CoV-2 in early March, but the number and geographic distribution of reporting commercial laboratories became stable enough to calculate a weekly percentage of specimens testing positive as of March 29, 2020.
                              View Data Table


                              Additional virologic surveillance information: Surveillance Methods


                              Outpatient/Emergency Department Illness


                              Two syndromic surveillance systems are being used to monitor trends in outpatient and emergency department visits that may be associated with COVID-19 illness. Each system monitors a slightly different syndrome, and together these systems provide a more comprehensive picture of mild to moderate COVID-19 illness than either would individually. Both systems are currently being affected by recent changes in healthcare seeking behavior, including increased use of telemedicine, compliance with recommendations to limit emergency department (ED) visits to severe illnesses, and increased practice of social distancing. These changes affect the numbers of people seeking care in the outpatient and ED settings and their reasons for doing so.
                              ILINet


                              The U.S. Outpatient Influenza-like Illness Surveillance Network (ILINet) provides data on visits for influenza-like illness (ILI) (fever [≥100F] and cough and/or sore throat) to approximately 2,600 primary care providers, emergency departments and urgent care centers in all 50 states, Puerto Rico, the District of Columbia and the U.S. Virgin Islands. Mild COVID-19 illness presents with symptoms similar to ILI, so ILINet is being used to track trends of mild to moderate COVID-19 illness and allows for comparison with prior influenza seasons.

                              Nationwide during week 26, 1.1% of patient visits reported through ILINet were due to ILI. This percentage is well below the national baseline of 2.4% but is increasing, which is atypical for this time of year. The pattern of increasing percentage of visits for ILI was reported for all age groups. Nationally, laboratory-confirmed influenza activity as reported by clinical laboratories is at levels usually seen during summer months which, along with changes in healthcare seeking behavior and the impact of social distancing, is likely contributing to the low level of ILI activity.

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                              * Age-group specific percentages should not be compared to the national baseline.

                              On a regional levelexternal icon, the percentage of outpatient visits for ILI ranged from 0.5% to 1.9% during week 26. All ten regions are below their region-specific baselines; however, Region 4 (South East) increased from 1.3% during week 25 to 1.7% during week 26, Region 6 (South Central) increased from 1.4% to 1.9% and Region 7 (Central) increased from 0.6% to 0.8%; Regions 2 (NY/NY/PR), 5 (Midwest), 8 (Mountain), 9 (South West/Coast) and 10 (Pacific Northwest) also reported slight increases.

                              Note: In response to the COVID-19 pandemic, new data sources will be incorporated into ILINet as we move into summer weeks when lower levels of influenza and other respiratory virus circulation are typical. Starting in week 21, increases in the number of patient visits will be seen as new sites are enrolled and the percentage of visits for ILI may change in comparison to previous weeks. While all regions remain below baseline levels for ILI, these system changes should be kept in mind when drawing conclusions from these data. Any changes in ILI due to changes in respiratory virus circulation will be highlighted here.
                              Overall Percentage of Visits for ILI | Age Group ILI Data

                              ILI Activity Levels


                              Data collected in ILINet are used to produce a measure of ILI activity for all 50 states, Puerto Rico, the District of Columbia and New York City. The mean reported percentage of visits due to ILI for the current week is compared to the mean reported during non-influenza weeks, and the activity levels correspond to the number of standard deviations below, at or above the mean.

                              The number of jurisdictions at each activity level during week 26 and the change compared to the previous week are summarized in the table below and shown in the following maps.
                              Activity Level Number of Jurisdictions
                              Week 26
                              (Week ending
                              June 27, 2020)
                              Compared to Previous Week
                              Very High 0 No change
                              High 0 No change
                              Moderate 0 No change
                              Low 1 No change
                              Minimal 52 +1
                              Insufficient Data 1 -1
                              *Data collected in ILINet may disproportionally represent certain populations within a state and may not accurately depict the full picture of influenza activity for the whole state. Differences in the data presented here by CDC and independently by some state health departments likely represent differing levels of data completeness with data presented by the state likely being the more complete.
                              National Syndromic Surveillance Program (NSSP): Emergency Department (ED) Visits


                              NSSP is a collaboration among CDC, federal partners, local and state health departments and academic and private sector partners to collect, analyze and share electronic patient encounter data received from multiple healthcare settings. To track trends of potential COVID-19 visits, visits for COVID-19-like illness (CLI) (fever and cough or shortness of breath or difficulty breathing or presence of a coronavirus diagnosis code) and ILI to a subset of emergency departments in 47 states are being monitored.

                              Nationwide during week 26, 2.7% of emergency department visits captured in NSSP were due to CLI and 0.9% were due to ILI. This is the second week of an increasing percentage of visits for CLI and ILI nationally since activity peaked in early April. Compared to week 25, 7 of 10 HHS regionsexternal icon (Regions 4 [South East], 5 [Midwest], 6 [South Central], 7 [Central], 8 [Mountain], 9 [South West/Coast] and 10 [Pacific Northwest]) reported increases in the percentages of visits for both CLI and ILI during week 26. One additional region, Region 1 (New England), reported a slight increase in percentage of visits for ILI during week 26.



                              Additional information about medically attended outpatient and emergency department visits for ILI and CLI: Surveillance Methods


                              Hospitalizations


                              The COVID-19-Associated Hospitalization Surveillance Network (COVID-NET) conducts population-based surveillance for laboratory-confirmed COVID-19-associated hospitalizations in select counties participating in the Emerging Infections Program (EIP) and the Influenza Hospitalization Surveillance Project (IHSP).

                              A total of 33,277 laboratory-confirmed COVID-19-associated hospitalizations were reported by sites between March 1, 2020 and June 27, 2020. The overall cumulative hospitalization rate was 102.5 per 100,000 population. Among the 0-4 years, 5-17 years, 18-49 years, 50-64 years, and 65 years age groups, the highest rate of hospitalization is among adults aged 65, followed by adults aged 50-64 years and adults aged 18-49 years.

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                              Overall 102.5
                              0-4 years 8.9
                              5-17 years 4.0
                              18-49 years 62.6
                              18-29 years 34.7
                              30-39 years 62.5
                              40-49 years 98.6
                              50-64 years 155.0
                              65+ years 306.7
                              65-74 years 222.5
                              75-84 years 370.1
                              85+ years 573.1
                              Among the 33,277 laboratory-confirmed COVID-19-associated hospitalized cases, 31,486 (94.6%) had information on race and ethnicity while collection of race and ethnicity was still pending for 1791 (5.4%) cases. Non-Hispanic American Indian or Alaska Native persons have an age-adjusted hospitalization rate approximately 5.7 times that of non-Hispanic White persons, non-Hispanic Black persons have a rate approximately 4.7 times that of non-Hispanic White persons, and Hispanic or Latino persons have a rate approximately 4.5 times that of non-Hispanic White persons. Additional data on race and ethnicity by age are available.



                              Non-Hispanic White persons and non-Hispanic Black persons represent the highest proportions of hospitalized cases reported to COVID-NET, followed by Hispanic or Latino, non-Hispanic Asian or Pacific Islander, and non-Hispanic American Indian or Alaska Native persons. However, some racial and ethnic groups are disproportionately represented among hospitalized cases as compared with the overall population of the catchment area. Prevalence ratios show a similar pattern to that of the age-adjusted hospitalization rates: non-Hispanic American Indian or Alaska Native persons have the highest prevalence ratio, followed by non-Hispanic Black, and Hispanic or Latino persons.
                              261.3 212.8 205.0 57.6 45.7
                              1.6% 32.5% 22.2% 4.7% 32.6%
                              0.7% 17.7% 14.0% 8.8% 58.8%
                              2.3 1.8 1.6 0.5 0.6
                              1COVID-19-associated hospitalization rates by race/ethnicity are calculated using hospitalized COVID-NET cases with known race and ethnicity for the numerator and NCHS bridged-race population estimates for the denominator. Rates are adjusted to account for differences in age distributions within race/ethnicity strata in the COVID-NET catchment area; the age strata used for the adjustment include 0-17, 18-49, 50-64, 65-74, 75-84, 85+ years.

                              2 Persons of multiple races (0.2%) or unknown race and ethnicity (6.2%) are not represented in the table but are included as part of the denominator.
                              3 Prevalence ratio is calculated as the ratio of the proportion of hospitalized COVID-NET cases over the proportion of population in COVID-NET catchment area.

                              Among 8,672 hospitalized adults with information on underlying medical conditions, 91% had at least one reported underlying medical condition. The most commonly reported were hypertension, obesity, chronic metabolic disease, and cardiovascular disease. Among 180 hospitalized children with information on underlying conditions, 51.7% had at least one reported underlying medical condition. The most commonly reported were obesity, asthma, and neurologic conditions.

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                              Additional data on demographics, signs and symptoms at admission, underlying conditions, interventions, outcomes, and discharge diagnoses, stratified by age, sex, and race and ethnicity, are available.

                              Additional hospitalization surveillance information: Surveillance Methods | Additional rate data | Additional demographic and clinical data


                              Mortality Surveillance


                              The National Center for Health Statistics (NCHS) collects death certificate data from vital statistics offices for all deaths occurring in the United States. Based on death certificate data available on July 2, 2020, 5.9% of all deaths occurring during the week ending June 27, 2020 (week 26) were due to pneumonia, influenza or COVID-19 (PIC). This is the tenth consecutive week of a declining percentage of deaths due to PIC. The percentage is equal to the epidemic threshold of 5.9% for week 26. Data for recent weeks are incomplete, and the PIC percentage may increase as more death certificates representing deaths during these weeks are processed.

                              Weekly mortality surveillance data include a combination of machine coded and manually coded causes of death collected from death certificates. Percentages of deaths due to PIC are higher among manually coded records than more rapidly available machine coded records. Due to the additional time needed for manual coding, the initially reported PIC percentages may be lower than percentages calculated from final data.

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                              *Data during recent weeks are incomplete because of the lag in time between when the death occurred and when the death certificate is completed, submitted to NCHS and processed for reporting purposes.
                              View Data Table


                              Additional NCHS mortality surveillance information: Surveillance Methods | Provisional Death Counts for COVID-19

                              More Information
                              View Page In:pdf icon 49 Pages, 2.45 MB
                              Page last reviewed: July 3, 2020
                              Content source: National Center for Immunization and Respiratory Diseases (NCIRD), Division of Viral Diseases

                              https://www.cdc.gov/coronavirus/2019...iew/index.html
                              Twitter: @RonanKelly13
                              The views expressed are mine alone and do not represent the views of my employer or any other person or organization.

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